| NPI | 1710932454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI B DONNELLY Owner 937-293-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: OH 35073167) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-06-02 |