Provider First Line Business Practice Location Address:
4803 KENTUCKY STREET
Provider Second Line Business Practice Location Address:
CAMC PEDIATRIC NEUROLOGY
Provider Business Practice Location Address City Name:
SOUTH CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25309-1547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-766-7695
Provider Business Practice Location Address Fax Number:
603-663-3229
Provider Enumeration Date:
10/13/2005