| NPI | 1891833570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN POWDERLY Owner 304-422-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2016-11-01 |