| NPI | 1972959534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE F GIBSON President 419-660-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH oh35079818) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |