| NPI | 1861916330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE C DAVES Practice Administrator 330-563-0617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-07-21 |