| NPI | 1487713400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW J. CROAK Owner 419-893-7134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery (Licence: OH 34-00-6843-C) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| 208800000X Urology | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: OH 07610-NP) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: OH NP-01213) | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: OH COA-16001) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2018-03-06 |