| NPI | 1285813428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JO ROBERTS Office Manager 304-637-8907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV WV 1917) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2008-04-20 |