| NPI | 1942256821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIAS HAIKAL President 304-755-0119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1111) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 11111) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-04-19 |