| NPI | 1346594801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN J MONTGOMERY Fnp 740-818-8416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: OH COA10766NP) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |