| NPI | 1639463722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BURKLEY Director 304-367-7315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |