Provider First Line Business Practice Location Address:
1423 COMMERCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26070-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-737-0816
Provider Business Practice Location Address Fax Number:
304-737-4338
Provider Enumeration Date:
10/15/2026