| NPI | 1215471016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM G CLARK Physician 330-456-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2017-01-05 |