| NPI | 1154436004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA P. FAULKNER Physician/Owner 304-431-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1040) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-04-15 |