| NPI | 1396798898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA N GROVES Credentialling Specialist 304-675-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WV 6) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 22650) |
| 363L00000X Nurse Practitioner | |
| 207P00000X Emergency Medicine | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363A00000X Physician Assistant | |
| 261QP1100X Clinic/Center, Podiatric | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WV 1441) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2026-05-06 |