| NPI | 1659574986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA LYNN MCFARLAND Corporation Secretary 937-233-0748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: OH 35043565M) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35058434M) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: OH 34003765F) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2009-10-15 |