| NPI | 1871773325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE MICHAEL HAZEL Doctor/President 937-399-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 35030442) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-14 |