| NPI | 1285782037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE LUCEY Billing Manager 304-243-7117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV WV1899, WV1898) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-01-23 |