Provider First Line Business Practice Location Address:
5187 US ROUTE 60 E
Provider Second Line Business Practice Location Address:
STE 11
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25705-2076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-399-5437
Provider Business Practice Location Address Fax Number:
304-399-1104
Provider Enumeration Date:
07/14/2008