| NPI | 1790269751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN BULANOV Owner 614-829-3015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2021-04-07 |