| NPI | 1477731727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD EVERETT LONGFELLOW President 740-392-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OH 1575) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: OH 1575) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2009-11-24 |