| NPI | 1790224400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETT GREEN Chief Executive Officer 304-252-6404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 6) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-23 |