| NPI | 1922976000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GIBSON VP Of Finance 304-598-4256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-29 |