| NPI | 1750833760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PUGAR Owner/D.O. 937-439-6186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019636) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |