| NPI | 1568026979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN WIRICK Owner 440-953-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |