| NPI | 1699279455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA K WILLIAMSON Practice Administrator 304-344-3551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |