| NPI | 1356721286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MCFARLANE-EL CEO 937-734-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 122300000X Dentist |
| 152W00000X Optometrist | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |