| NPI | 1417947037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEATHA MAE ROSS Director 937-775-2552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN-238463) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2014-12-08 |