Provider First Line Business Practice Location Address:
2001 3RD AVE.
Provider Second Line Business Practice Location Address:
MARSHALL UNIVERSITY
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-696-4305
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007