| NPI | 1215136460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SIMMAN President 937-384-0780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 1706540) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2016-09-13 |