| NPI | 1841479813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER FALLON MOLLICA Office Manager 304-267-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: WV WV00358) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2016-03-04 |