| NPI | 1770603383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P SCHULTZ Owner 304-723-3967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-09-17 |