| NPI | 1730469594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA HOLMES WHITE Executive Director 304-414-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 08954) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |