NPI | 1114109683 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES HUNT Exuctive Director 304-252-8324 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
2085U0001X Radiology, Diagnostic Ultrasound | |
Enumeration Date | 2007-11-27 |
Last Update Date | 2012-05-30 |