| NPI | 1932434149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DONOVAN BECKETT Owner/Authorized Official 304-235-1844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: WV 1875) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2015-02-20 |