| NPI | 1851090401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A MARSHALL CFO 330-315-3708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2025-09-04 |