| NPI | 1053437327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY J. GODFREY President 304-485-6563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2022-07-21 |