Provider First Line Business Practice Location Address:
2511 3RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25703-1614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-522-7333
Provider Business Practice Location Address Fax Number:
304-522-4194
Provider Enumeration Date:
09/25/2006