| NPI | 1629241278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA J. ANDREINI Secretary/Treasurer 304-277-1766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 14036) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35057824) |
| 174400000X Specialist (Licence: NJ 25MAO4456100) | |
| 174400000X Specialist (Licence: PA MD034699E) | |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-05-22 |