| Organization Name: | SPRINGBORO MEDICAL ARTS, INC. |
| NPI Number: | 1205093390 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DESIDERIO NMI PINA (MEDICAL DIRECTOR) |
| Mailing Address: | 84 Remick Blvd Springboro |
| State: | OH US |
| Postal Code: | 450669168 |
| Phone Number: | 9376190444 |
| Fax Number: | 9376190445 |
| NPI Enumeration Date: | 05/18/2008 |
| NPI Last Update Date: | 05/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |