| NPI | 1780962704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD KENT MITCHELL Chief Executive Officer 304-225-7549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 20482) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |