Provider First Line Business Practice Location Address:
1235 BUFFALO CREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-429-2297
Provider Business Practice Location Address Fax Number:
304-429-8365
Provider Enumeration Date:
12/05/2006