NPI | 1497135719 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTINA A MACIUNAS Director Physician 304-261-0313 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WV 17514) |
Enumeration Date | 2015-06-02 |
Last Update Date | 2015-06-02 |