| NPI | 1518908698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYNN DIEHL Insurance Claims Processor 330-833-5692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH oh35060119) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-08-22 |