Provider First Line Business Practice Location Address:
NUTTALL MIDDLE SCHOOL
Provider Second Line Business Practice Location Address:
ROUTE 60
Provider Business Practice Location Address City Name:
LOOKOUT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-574-1144
Provider Business Practice Location Address Fax Number:
304-574-1144
Provider Enumeration Date:
12/26/2007