| 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 |