NPI | 1356780639 |
---|---|
Doing Business As | ROBERT C. BYRD HIGH WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | DORA L POTASNIK Credentialing 304-587-2541 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WV 2287-7373) |
Enumeration Date | 2013-06-19 |
Last Update Date | 2013-06-19 |