| NPI | 1740655471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH MOENICH Physician Assistant 440-539-0929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 085.005738) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: OH 004508) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |