| 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 |