| NPI | 1275712879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE TURNER Credentialing Coordinator 440-988-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35062523) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2009-12-14 |