Provider First Line Business Practice Location Address:
105 ADAIR ST
Provider Second Line Business Practice Location Address:
RALEIGH CO BOARD OF EDUCATION
Provider Business Practice Location Address City Name:
BECKLEY
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-256-4500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2008