| NPI | 1548988215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA LEELYN FINNERTY Administrator 740-405-3873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2023-01-06 |