| NPI | 1194810929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM REEVES MINOR Medical Doctor 304-285-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 729) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS006467E) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2011-03-15 |