| NPI | 1649610437 |
|---|---|
| Doing Business As | BIG ELM ELEMENTARY WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | DORA L POTASNIK Credentialing 304-587-2541 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WV 2287-8118) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |