| NPI | 1265615728 |
|---|---|
| Doing Business As | JACKSON COUNTY SCHOOL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | VICKI L. KNICELY Billing/Credentialing Supervisor 304-275-3301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2014-01-03 |