| NPI | 1417626425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA PATRICK CHAPMAN Owner /Doctor 304-744-1251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2022-02-08 |