| NPI | 1952581274 |
|---|---|
| Doing Business As | LICKING MEMORIAL GERIATRIC MEDICINE AT LPN |
| Entity Type | Organization |
| Authorized Contact | THOMAS N. POULSON CFO 740-348-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |