Provider First Line Business Practice Location Address:
6 QUAIL VALLEY MEDICAL CTR
Provider Second Line Business Practice Location Address:
200 NEW HOPE RD.
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
24740-2139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-425-9471
Provider Business Practice Location Address Fax Number:
304-425-2127
Provider Enumeration Date:
06/30/2005