| NPI | 1215201355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATA LAKKIMSETTY Physician 419-508-4608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 67138) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 67138) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |