| NPI | 1558695411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOELLE LONG Office Manager 740-376-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2012-05-09 |