| NPI | 1952402463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE L NUNLEY Practice Manager 304-757-2541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: WV 042197) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-06-10 |