NPI | 1154712032 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER GROSE CEO 304-250-6047 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 77359) |
Enumeration Date | 2015-02-12 |
Last Update Date | 2015-02-12 |