| NPI | 1518940881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE A MONTGOMERY President 419-897-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34004231M) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2013-07-29 |