| NPI | 1326166463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASIDHARAN TARAVATH President 304-757-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: WV 18764) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2014-03-11 |