| NPI | 1982714358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK T ROTHSTEIN Executive Director 740-566-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-08-30 |