| Organization Name: | USIMC OF WEST VIRGINIA MEDICAL CORPORATION |
| NPI Number: | 1528345675 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIANNE LINDROTH (OWNER) |
| Mailing Address: | 25 Atlantic Ave Erlanger |
| State: | KY US |
| Postal Code: | 410183151 |
| Phone Number: | 8597466630 |
| Fax Number: | |
| NPI Enumeration Date: | 11/03/2011 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |