NPI | 1104962729 |
---|---|
Other Name | FORT ASHBY FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | PAUL TAYLOR LIVENGOOD Owner 304-298-3605 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: WV 11172) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2016-11-01 |