| NPI | 1548526791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO ACOSTA VILLARREAL Owner 937-294-3850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 37990) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |