NPI | 1902298466 |
---|---|
Entity Type | Organization |
Authorized Contact | SUMMER MICHELLE KIRBY CEO 740-351-1514 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207Q00000X Family Medicine |
251S00000X Community/Behavioral Health | |
261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) | |
261QP2300X Clinic/Center Primary Care | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2015-02-20 |
Last Update Date | 2024-05-06 |