| NPI | 1811488562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN DAVID ALLEN Director 419-252-5734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |