Provider First Line Business Practice Location Address:
705 GARFIELD AVE
Provider Second Line Business Practice Location Address:
MEDICAL OFFICE BLDG. B., SUITE 180
Provider Business Practice Location Address City Name:
PARKERSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26101-5444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-274-0790
Provider Business Practice Location Address Fax Number:
304-424-2717
Provider Enumeration Date:
08/21/2006