Provider First Line Business Practice Location Address:
200 ORTHOPEDIC WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26505-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-599-0720
Provider Business Practice Location Address Fax Number:
304-599-3962
Provider Enumeration Date:
06/30/2005