| NPI | 1730378621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN A CONOVER Business Manager 937-293-6188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 35065836) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |