Provider First Line Business Practice Location Address:
1230 SIXTH AVENUE
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:
25701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-526-9100
Provider Business Practice Location Address Fax Number:
304-526-9375
Provider Enumeration Date:
11/06/2006