| NPI | 1811715436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON HENNESSEY Authorized Official 304-282-4929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2025-10-08 |