| NPI | 1154734465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L KNOX Office Manager 304-343-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 12093) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 19845) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2015-01-07 |