| NPI | 1235596677 |
|---|---|
| Former Legal Business Name | MEDCORP-TYGART VALLEY MEDICAL SPECIALTIES |
| Entity Type | Organization |
| Authorized Contact | STEPHEN CROSS CEO 304-637-6302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WV 21597) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-03-16 |