| NPI | 1760358345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GROVER GLENDON KERNS VP Of Finance 304-260-1443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |