| NPI | 1922206291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L HODGES Office Manager 330-722-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35077002B) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002583) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2009-12-14 |