| NPI | 1700098811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM LACEY President 740-376-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35066931L) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: OH 35066931L) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: OH 35066931L) | |
| 2084N0600X (Licence: OH 35066931L) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-17 |