| NPI | 1912660754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY LYNN MITCHELL Office Manager 304-614-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-01-27 |