| NPI | 1639691629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MADU Nurse Practitioner 740-414-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.127057) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35.088677) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.15280) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-07-11 |