| NPI | 1275501660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LAMM KNEISLEY Practice Administrator 937-328-8850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-07-21 |