| NPI | 1023531449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M. KYLE Owner/CEO 304-860-0360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: WV 12360) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-10-09 |