| NPI | 1811221187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGY SHAFERLY Owner 419-672-8981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 35056199) |
| Enumeration Date | 2009-09-19 |
| Last Update Date | 2009-09-19 |