| NPI | 1871528380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHN MIRABILE President 304-425-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 12913) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-06-24 |