| NPI | 1629263314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GLANDON Billing/Receptionist 740-779-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35073408) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2007-09-06 |