| NPI | 1891945044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KING Billing/Reimbursement 330-823-3856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35057172) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-10-29 |