| NPI | 1003797234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 176B00000X Midwife |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-09-12 |
| Last Update Date | 2025-09-12 |