| NPI | 1568137719 |
|---|---|
| Doing Business As | DTNA - GASTONIA OCC |
| Entity Type | Organization |
| Authorized Contact | JON LEIZMAN President 216-479-9063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2022-08-24 |