| NPI | 1417229329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL ROSAS Physician 304-252-0609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WV 2012003732) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2017-12-11 |