| NPI | 1750378345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE HILL CEO 304-872-8402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 61) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WV 51D0933140) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: WV 61) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2010-09-22 |