| NPI | 1467084459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON DUFFY Owner 304-671-2582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |