| NPI | 1801328513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LOU BROWN Sole Proprieter 614-579-0356 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH 33.006980) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |