| NPI | 1770697278 |
|---|---|
| Doing Business As | MVA FAIRMONT CLINIC |
| Entity Type | Organization |
| Authorized Contact | NANCY L VANDERGRIFT President 304-366-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2019-06-05 |