| NPI | 1619481108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SCOTT CANFIELD Partner 614-286-1513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: OH 30.023922) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023922) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2022-07-25 |