| NPI | 1932269024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI K OTT Office Manager 304-728-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: WV 19784) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |