| NPI | 1811162332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J RUPPEL Treasurer 419-334-6661 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 9402230450) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |