| NPI | 1821925199 |
|---|---|
| Other Name | 807 FARSON ST STE 203C |
| Entity Type | Organization |
| Authorized Contact | PAUL G WESTBROCK VP, Legal Affairs 740-374-1581 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2026-05-08 |
| Last Update Date | 2026-05-08 |