| NPI | 1962696112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN HOWARD CUNNINGHAM Owner, Member 304-345-4770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WV 09984) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-11-30 |