| NPI | 1760473425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT J PAINE President 304-255-2724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WV 1351) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2015-07-23 |