| NPI | 1427329473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA ANN WEBSTER CEO 567-868-6878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 48182140) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |