Provider First Line Business Practice Location Address:
#1 HEALTH CARE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPPI
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-457-1760
Provider Business Practice Location Address Fax Number:
304-457-3781
Provider Enumeration Date:
10/03/2007