| NPI | 1902298466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER MICHELLE KIRBY CEO 740-351-1514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251S00000X Community/Behavioral Health | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2024-05-06 |