| NPI | 1750650925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE M BEYMAN R.Pn 330-867-1946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 03321689) |
| Enumeration Date | 2011-12-18 |
| Last Update Date | 2011-12-18 |