NPI | 1184272296 |
---|---|
Entity Type | Organization |
Authorized Contact | RALPH ELI LEBLANC Medical Director 304-813-8332 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2019-09-02 |
Last Update Date | 2019-09-02 |