NPI | 1285904623 |
---|---|
Entity Type | Organization |
Authorized Contact | CATHY MARIE FUNK Owner/Physician 304-264-9837 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 99SEV) |
Enumeration Date | 2012-01-03 |
Last Update Date | 2012-10-22 |