| NPI | 1891965737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY JEAN WILLIS Doctor 304-465-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 708 OD) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-10 |