| NPI | 1407024870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WIERSMA CEO 440-233-1059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 122300000X Dentist |
| 204E00000X Oral & Maxillofacial Surgery | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2013-06-21 |