| NPI | 1467826453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GOR Owner 614-300-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 34006086) |
| 208D00000X General Practice | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory (Licence: OH 34006086) | |
| Enumeration Date | 2015-11-14 |
| Last Update Date | 2024-09-23 |