| Name | PROVIDENCE MEDICAL GROUP, INC. |
|---|---|
| Street | 2912 SPRINGBORO W |
| City | DAYTON |
| Zip | OH 45439 |
| Status | Active |
| Effective date | 2017-07-18T00:00:00+02:00 |
| Company | CROSSROADS FAMILY PRACTICE |
|---|---|
| Entity Number | 4052286 |
| Company | CROSSROADS FAMILY MEDICINE |
|---|---|
| Entity Number | 4052287 |