| NPI | 1326567512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DEAN Clo 614-949-0287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |