| NPI | 1497804975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GALVIN Administrator 937-294-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: OH 0444AS) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |