| NPI | 1548331960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL GORDON SCHOWENGERDT Director 740-454-3217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: OH 35025730) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 35025730) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2025-09-11 |