| NPI | 1275927840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GENE JOHNSON Medical Director 330-536-7461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-27 |