| NPI | 1659916294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERI L MALONE Billing Manager 740-532-4858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |