| NPI | 1154411908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY A VAUGHAN Physician President 304-733-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: WV 18579) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |