Provider First Line Business Practice Location Address:
1600 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 3400
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-3656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-691-1704
Provider Business Practice Location Address Fax Number:
304-691-1725
Provider Enumeration Date:
01/05/2007