| NPI | 1962823708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD OSBORNE Credentialing Specialist 614-274-1544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2022-03-11 |