| NPI | 1164817763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN D. SMITH Owner 304-860-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN49209-FNP-BC) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |