| NPI | 1841661758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MINORIK CEO 330-607-8464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.007428) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2016-04-29 |