| NPI | 1407162696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW E LANDIS President 304-255-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WV 11229) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2012-01-11 |