| NPI | 1588991418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN E YOUNG Executive Director 937-548-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2025-03-24 |