| NPI | 1467031997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE MORTON Cmo 740-607-4835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-08-25 |