| NPI | 1275516528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY MCLEAR Billing/Credentialing Manager 419-893-7671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34004485) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-12-12 |