Provider First Line Business Practice Location Address:
600 CHURCH ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIPLEY
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25271-1666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-372-2222
Provider Business Practice Location Address Fax Number:
304-372-4215
Provider Enumeration Date:
12/30/2005