Provider First Line Business Practice Location Address:
3 HOSPITAL PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26301-9316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-623-1330
Provider Business Practice Location Address Fax Number:
304-623-1333
Provider Enumeration Date:
09/20/2006