| NPI | 1285172163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY MOYER Physician Assistant 419-824-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004996RX) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |