| 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 |