Provider First Line Business Practice Location Address:
911 EMERGENCY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PT PLEASANT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25550-2005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-675-6134
Provider Business Practice Location Address Fax Number:
304-675-7433
Provider Enumeration Date:
07/13/2005