| NPI | 1912652454 |
|---|---|
| Former Legal Business Name | BRIDGE ROAD PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | ERICA D GUNNOE Nurse Practitioner 304-437-9705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-02-14 |