| NPI | 1841247368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DOUGLAS WHITE President 304-574-1890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 14161) |
| Enumeration Date | 2006-05-29 |
| Last Update Date | 2020-08-22 |