| NPI | 1285396978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA SUE MELVIN President 740-208-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-10-10 |
| Last Update Date | 2023-10-09 |