Provider First Line Business Practice Location Address:
20 HOSPITAL DR
Provider Second Line Business Practice Location Address:
DOCTORS PARK
Provider Business Practice Location Address City Name:
LOGAN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25601-3452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-374-4000
Provider Business Practice Location Address Fax Number:
410-374-5000
Provider Enumeration Date:
10/17/2008