| NPI | 1215311444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY COLEMAN Practice Administrator 304-720-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN76968-NP-C) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |