| NPI | 1972856524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA OUTWATER Office Manager 330-869-2635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH 003740) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-19 |