NPI | 1962178269 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA E MCCARTY Owner/Administrator 304-615-9925 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
Enumeration Date | 2021-08-18 |
Last Update Date | 2021-08-30 |