| NPI | 1003072398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK L HOUDERSHELDT CEO 304-757-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 789) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2020-04-01 |