| NPI | 1700968351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOSEPH BERENS President/Owner 304-258-4408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 16621) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |