| NPI | 1740306463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME ANTHONY DENMARK Director 937-610-2703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN088678) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |