NPI | 1548304074 |
---|---|
Doing Business As | WILDWOOD FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | KENYA DIXON Credentialing Assistant 419-824-7288 |
Organization Subpart ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
208000000X Pediatrics | |
Enumeration Date | 2007-02-17 |
Last Update Date | 2008-02-18 |