| NPI | 1639474562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN EDWARD GLASSER Business Manager 304-645-1890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WV 183500000X) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |