| NPI | 1023309580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL C. BOWN Owner 304-768-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 20411) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WV 20411) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-05-02 |