NPI | 1730347402 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN WITCHEY Director 304-262-9600 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WV UD000018511001) |
Enumeration Date | 2008-05-29 |
Last Update Date | 2008-05-29 |