| NPI | 1164398319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 208600000X Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-15 |