| NPI | 1154690931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR STUART CORNETT Doctor 304-252-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2012-10-10 |