| NPI | 1912989526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN PALEY Partner 937-424-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 0730AS) |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology (Licence: OH 1073-1C) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-08-22 |