NPI | 1558323006 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE BRIAN JALAZO President 304-263-0913 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 926720595) |
Enumeration Date | 2006-04-03 |
Last Update Date | 2020-08-22 |