| NPI | 1285821561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R. CARSON President 304-880-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: WV WV18114) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2008-12-29 |