| NPI | 1639308471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBYN MCDANIEL Provider Relations Supervisor 304-293-5033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |