| NPI | 1891818878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY R. PENTASUGLIA Credentialling/Billing Specialist 304-431-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 1596) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2025-07-30 |