| NPI | 1255773123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE YASMEEN SADOUN Owner 614-806-8729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P2163) |
| Enumeration Date | 2013-07-21 |
| Last Update Date | 2013-07-21 |