| NPI | 1396816708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JEFFERSON WYSOR Physician 419-625-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-047619) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |