| NPI | 1144462912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE BOYD Office Manager 304-342-8142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 13419) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |