| NPI | 1730607870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN KING Owner 304-252-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 49327) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2023-01-26 |