NPI | 1073700837 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBRA C CRITES-SAMS Owner/Physician 304-645-4406 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV E35409) |
Enumeration Date | 2007-09-26 |
Last Update Date | 2007-11-27 |