| NPI | 1902520208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MUSSON Physician 330-242-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2023-06-20 |