| NPI | 1720083975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADLA ADI President 304-345-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 09228) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: WV 1825) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |