| NPI | 1700236478 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TERRANCE MORTON Cmo 740-607-4835 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2016-06-14 | 
| Last Update Date | 2025-08-25 |