| NPI | 1811392442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN R REXRODE Physician Director 304-358-7565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: WV 1035-5878) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |