Provider First Line Business Practice Location Address:
UNITED SUMMIT CENTER
Provider Second Line Business Practice Location Address:
#6 HOSPITAL PLAZA
Provider Business Practice Location Address City Name:
CLARKSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-623-5661
Provider Business Practice Location Address Fax Number:
304-623-2989
Provider Enumeration Date:
07/28/2006