| NPI | 1619915170 |
|---|---|
| Former Legal Business Name | BRYAN MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DIANE CONRAD Medical Director 419-636-4517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2019-02-25 |