| NPI | 1326256041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN D TREMBUSH Dc Administrator 304-225-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: WV 769) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WV 769) |
| 225100000X Physical Therapist (Licence: WV PT2330) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-01-13 |