Provider First Line Business Practice Location Address:
1600 MEDICAL CENTER DRIVE
Provider Second Line Business Practice Location Address:
STE G500
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-691-1262
Provider Business Practice Location Address Fax Number:
304-691-1666
Provider Enumeration Date:
03/15/2006