NPI | 1184879660 |
---|---|
Entity Type | Organization |
Authorized Contact | BARBARA ANN SHARPS Owner 304-368-9393 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WV 726D) |
Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: WV 727D) |
Enumeration Date | 2008-11-25 |
Last Update Date | 2009-04-17 |