| NPI | 1134331812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY GREGORY JUCKETT Assoc. Professor Of Family Medicine 304-293-1369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: WV 13865) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |