Provider First Line Business Practice Location Address:
5480 BIG TYLER RD
Provider Second Line Business Practice Location Address:
SUMMIT COUNSELING
Provider Business Practice Location Address City Name:
CROSS LANES
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25313-1116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-539-2789
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2007