NPI | 1679917553 |
---|---|
Doing Business As | INSHAPEWV |
Entity Type | Organization |
Authorized Contact | JAMES R ELLIS Nurse Practitioner/Owner 681-238-5258 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WV 50904) |
Enumeration Date | 2013-04-23 |
Last Update Date | 2019-05-15 |