| NPI | 1073502522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC N. FERRERA Owner 740-283-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35-041927F) |
| Additional Taxonomies | 208800000X Urology (Licence: WV 13862) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2020-05-12 |