Provider First Line Business Practice Location Address:
1 SUTPHIN DR
Provider Second Line Business Practice Location Address:
MARMET HEALTH CARE
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25315-1977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-949-1890
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2010