Provider First Line Business Practice Location Address:
527 MEDICAL PARK DRIVE, STE. 204
Provider Second Line Business Practice Location Address:
ASSOCIATED SPECIALISTS, INC.
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-933-3800
Provider Business Practice Location Address Fax Number:
304-933-3814
Provider Enumeration Date:
08/15/2006