| NPI | 1285809608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENEAL MARIE CAW Human Resourses Specialist 724-287-4781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: PA PN100174L) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2008-04-27 |