| NPI | 1659540136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD LANE Physician 614-451-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 34004829) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-06-17 |