| NPI | 1891829768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL LEROY WIDMER Physician 330-925-3857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35071171W) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |