| NPI | 1255521514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY P SMITH CEO 419-626-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35059687) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35059687) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2009-02-16 |