Provider First Line Business Practice Location Address:
8417 US ROUTE 60 STE 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARBOURSVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25504-7662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-963-1964
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/02/2026