| NPI | 1851354633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M KOSTELNICK Practice Administrator 330-899-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-08-14 |