| NPI | 1831240381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY A SHANK Owner 419-266-5762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH np03335) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |