| NPI | 1801188842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GRANT GOODWIN Owner 937-291-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 1982) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2011-05-10 |