| NPI | 1639616006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH W. SELLS Owner 304-752-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: WV 1489) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |