| NPI | 1962896969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISANNE GORDON Physician 937-578-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation (Licence: OH 35042915) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |