| NPI | 1871961771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH MEESIG Chief Of Staff 740-773-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: OH 35050128) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |