| NPI | 1922026988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN STANLEY WALLS Administrator 304-255-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-01-29 |