| NPI | 1821654674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLEY ROMAN Owner 614-706-5206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-05-17 |