| NPI | 1538426168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDWARD REAGAN Executive Director 419-244-0135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |