| NPI | 1225526304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM JAFARY RANA Physian Assistant 304-222-5817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: WV 1717) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2023-04-12 |