| NPI | 1982720645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVARO RAFAEL GUTIERREZ Owner 304-594-3258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WV 14079) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2013-03-14 |