| NPI | 1669453189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LEA LEWIS Office Manager 740-474-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35042158B) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35071002J) |
| 207Q00000X Family Medicine (Licence: OH 35053974M) | |
| 207Q00000X Family Medicine (Licence: OH 350463858) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2019-12-11 |