| NPI | 1205536695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A MARSHALL CFO 330-315-3708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261Q00000X Clinic/Center | |
| 291U00000X Clinical Medical Laboratory | |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2025-09-03 |