NPI | 1376713925 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIE JOAN MODIE Medical Biller 330-225-7733 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2008-03-10 |
Last Update Date | 2011-11-02 |