NPI | 1518751858 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208800000X Urology |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2025-04-09 |
Last Update Date | 2025-04-09 |