| NPI | 1801098512 |
|---|---|
| Doing Business As | OICC, PRIMARY CARE NETWORK |
| Entity Type | Organization |
| Authorized Contact | PATRICIA D BRASSE Credentialing Representative 937-426-1518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2009-06-24 |