| NPI | 1558567636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY BURMEISTER Administrative Director, Finance 419-891-8024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 89211) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-07-21 |