Provider First Line Business Practice Location Address:
115 SUMMERS HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HINTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25951-5172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-466-1000
Provider Business Practice Location Address Fax Number:
304-466-1690
Provider Enumeration Date:
11/10/2005