| NPI | 1265505143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D HAZELETT Administrator 304-523-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2016-11-23 |