| NPI | 1285765008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOSHA R. WESTFALL Practice Manager 740-687-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 207Q00000X) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2019-12-31 |