| NPI | 1013083823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY B WILPS President 304-797-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WV 00238) |
| Additional Taxonomies | 213ER0200X Podiatrist Radiology (Licence: WV 00238) |
| 213ES0000X Podiatrist Sports Medicine (Licence: WV 00238) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WV 00238) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |