| NPI | 1841160272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY FAHLE Nurse Practitioner 937-935-7461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2025-11-10 |