| NPI | 1831747328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT COOPER Director 614-293-8305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |