| NPI | 1457788176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT HENRY BAYLISS Cnp 614-507-9604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage (Licence: OH COA 12022-NP) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |