| NPI | 1487320958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA MICHELLE WATTS Owner/Authorized Official 614-425-7968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |