| NPI | 1811585144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY GINGERICH Owner 937-623-1975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2021-01-03 |
| Last Update Date | 2021-01-03 |