| NPI | 1821358417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA L. POWELL Billing Clerk 740-695-5190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-066409) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |