| NPI | 1104318625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ROLAND WHYTE Owner 304-250-0382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WV 22852) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-06-18 |