| NPI | 1225268808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN M MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |