| NPI | 1407040918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM J NICE Doctor 440-585-5258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35036891) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2011-01-07 |