| NPI | 1487849485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J LEWIS Owner/Physician 304-926-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 18980) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |