| NPI | 1225410830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLY KNOWLTON Nurse Practitioner 740-629-8528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: OH NP08402) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |