| NPI | 1407945926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN F. LANE Authorized Official 419-373-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 35.086946) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |