NPI | 1912250663 |
---|---|
Entity Type | Organization |
Authorized Contact | MEHRAN KHAJAVI Owner/Physician 304-264-0888 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 22758) |
Enumeration Date | 2012-10-18 |
Last Update Date | 2020-02-11 |