| NPI | 1568169365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JOSEPH Owner 330-853-6477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |