| NPI | 1487951836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACHELLE GIORDON Credentialing Specialist 330-723-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35093867) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2011-04-18 |