| NPI | 1780799775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GERARD PROVAZNIK President/CEO 740-574-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34005337) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2010-05-18 |