| NPI | 1407072663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO H AGBAYANI Doctor 304-596-6911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 19905) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2013-04-15 |