| NPI | 1306383153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MISJA Owner 937-681-9507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: OH RT851444) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |