NPI | 1861050635 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY RALSTON System Director 419-996-5119 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 174400000X Specialist |
207QG0300X Family Medicine, Geriatric Medicine | |
207R00000X Internal Medicine | |
207RS0010X Internal Medicine, Sports Medicine | |
208000000X Pediatrics | |
251E00000X Home Health | |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2019-06-05 |
Last Update Date | 2021-03-02 |