| NPI | 1386938827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY J RICHARDSON Managing Member 304-634-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV WV18236) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |