| NPI | 1306419734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA R BLANKENSHIP Owner 304-553-5232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |