| NPI | 1245432087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN BAKE Lpn 614-599-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH pn082384) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |