| NPI | 1063883023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS ALLEN EUGENE SCHILDT Owner, President 304-264-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 23075) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2021-03-04 |