| NPI | 1902354095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM R ROUTH Owner 614-957-5268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 34008410) |
| Enumeration Date | 2016-09-17 |
| Last Update Date | 2017-02-26 |