| NPI | 1538330519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JAMES SHAFFER Owner 304-205-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 22835) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |