| NPI | 1598966871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDEEP VARDAN Owner 276-582-0888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WV 19508) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: VA 0101220759) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2016-04-01 |