| NPI | 1679802623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA A BEVIS Credentialing Administrator 513-961-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-100017) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 35-100017) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35-100017) | |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |