Provider First Line Business Practice Location Address:
57 SUTPHIN LN
Provider Second Line Business Practice Location Address:
NEW RIVER HEALTH SBH
Provider Business Practice Location Address City Name:
SCARBRO
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25917-8817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-465-1378
Provider Business Practice Location Address Fax Number:
304-469-2981
Provider Enumeration Date:
03/09/2006