| NPI | 1528181203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIREN K REAHL Owner 304-342-3891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 18694) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 18695) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |