| NPI | 1821117102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES VALONE President 419-334-7191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 003421) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2012-03-15 |