| NPI | 1548643893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T ROSS Owner 740-266-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35.077833) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 35.077833) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2022-07-21 |