| NPI | 1780935254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY HUBBARD Practice Manager 513-737-0257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2021-07-09 |