| NPI | 1679865430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GERARD COWENS Owner 330-539-9039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: OH 35054169) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35054169) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |