| NPI | 1790442077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A. FRANGOS Sole Member 304-992-9622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2023-09-06 |