| NPI | 1043594971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN FOWLER CEO 304-526-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2015-11-20 |