| NPI | 1710365549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO GARCIA Owner 304-260-1436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 23951) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WV 24385) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-10-14 |