| NPI | 1578041182 |
|---|---|
| Doing Business As | MVA EAST FAIRMONT MIDDLE SCHOOL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | NANCY LOUISE VANDERGRIFT President 304-367-8740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WV 1034-6686) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2022-03-22 |