Provider First Line Business Practice Location Address:
1824 MURDOCH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARKERSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26102-0327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-424-4881
Provider Business Practice Location Address Fax Number:
304-424-4782
Provider Enumeration Date:
05/23/2007