| NPI | 1144973116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS L WATSON Executive Director 724-825-5527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-10-11 |