| NPI | 1821521154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MANCHIN Physician 304-848-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WV APRN83843-NP-C) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |