| NPI | 1790819373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKLIN SCOTT MOORE Owner 304-768-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 1390) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-10-16 |