| NPI | 1245691393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HENDERSON Credentialing Manager 513-685-0949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |