| NPI | 1326539834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL LEGG Owner 614-625-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WA 60674447) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |