| NPI | 1740685932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALIA B SOTOMAYOR VALENZUELA Pediatric Pulmonologist/Owner 304-284-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 22524) |
| 2080P0214X Pediatrics, Pediatric Pulmonology | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2023-03-07 |