| NPI | 1578505228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM LONGVILLE Chief Accounting Officer And Contro 216-636-7416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 174400000X Specialist |
| 208D00000X General Practice | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-09-17 |