| NPI | 1437426780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD S TRENBATH President 304-645-4043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 12758) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WV 12758) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2016-10-10 |