Provider First Line Business Practice Location Address:
110 MORDINGTON AVENUE
Provider Second Line Business Practice Location Address:
JEFFERSON COUNTY BOARD OF EDUCATION
Provider Business Practice Location Address City Name:
CHARLES TOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-725-9741
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2008