| NPI | 1649717786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA C JARRELL President 937-219-5547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH NP08619) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |