| NPI | 1952370561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB MICKEY Revenue Cycle Coordinator/Credentia 419-693-0631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 0231) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2020-05-14 |