| NPI | 1952708786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL W WILSON Owner 419-386-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 34002939W) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |