| NPI | 1699895375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE ROY Owner/Authorized Official 304-250-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 18180) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-05-10 |