| NPI | 1942699608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON BOWEN Medical Director 304-855-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: WV 22652) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |