| 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 |