| NPI | 1871791475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY VILLARREAL Clinical Instructor House Staff 614-293-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |