| NPI | 1275624918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN SOUTHWORTH Doctor 937-322-8977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD020413E) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35.062754) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |