| NPI | 1578989216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE FUNK Medical Biller 304-274-0928 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0031880) |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-04-08 |