| NPI | 1811983364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL GUERRA Administrator 419-627-8557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 0628AS) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-08-22 |