| NPI | 1245625581 |
|---|---|
| Doing Business As | MEDICAL OFFICE BUILDING-BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | ANDREA M RUMBLE Provider Enrollment Specialist 304-285-7101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 208VP0000X | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-04-03 |