NPI | 1639412398 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID DIDDEN Sole Member 304-876-2447 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 21679) |
Enumeration Date | 2013-04-01 |
Last Update Date | 2013-04-01 |