| NPI | 1538266739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L HAGERMAN Owner 419-335-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35076863) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35082560) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-12-16 |