Provider First Line Business Practice Location Address:
3075 US ROUTE 60
Provider Second Line Business Practice Location Address:
DOOR D
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25705-8859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-399-4422
Provider Business Practice Location Address Fax Number:
304-399-4433
Provider Enumeration Date:
06/12/2006