| NPI | 1972097707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHONDA BOND Medical Billing Manager 614-340-6717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |