| NPI | 1548405665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE HARRIS COO 216-765-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2019-09-19 |