| NPI | 1386988004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C BOURLAND Secretary/Treasurer 614-442-2431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2013-10-02 |