Provider First Line Business Practice Location Address:
1616 13TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-1692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-522-8800
Provider Business Practice Location Address Fax Number:
304-523-4303
Provider Enumeration Date:
08/12/2008