| NPI | 1215702576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KNICELY VP Corpdev 304-273-8090 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 207R00000X Internal Medicine | |
| 363LA2100X Nurse Practitioner Acute Care | |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-11-16 |