| NPI | 1962455196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE KLEEH Practice Manager 330-758-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OH OH34004337) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-12-08 |