| NPI | 1316492200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIE REED Practice Manager 304-720-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN82678-FNP-BC) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-08-20 |