| NPI | 1265851356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACHELLE GIORDON Credentialing Specialist 330-723-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KS KS04-37015) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |