| NPI | 1285784587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W JACKSON Partner 419-843-4836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OH 34005219) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2013-09-09 |