| NPI | 1265295315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CORNISH Admin 419-779-7692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 164W00000X Licensed Practical Nurse | |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-02 |