| NPI | 1255734711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN QUILLEN Executive Director 740-283-2856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH AN1558329) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |