| NPI | 1710130018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA BURNICH Office Manager 330-758-4568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34-00-2093) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2010-05-03 |