| NPI | 1487953634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEAN WALDRON President 419-303-3466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35052128) |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2011-03-26 |