NPI | 1992334858 |
---|---|
Entity Type | Organization |
Authorized Contact | KEITH WAYNE HOSTETLER Owner 330-625-4900 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
261QI0500X Clinic/Center, Infusion Therapy | |
Enumeration Date | 2020-04-03 |
Last Update Date | 2023-03-29 |