| NPI | 1518291517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE D HARRIS Office Manager 937-228-4942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35073109) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-12-16 |