Provider First Line Business Practice Location Address:
2121 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARKERSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26101-3803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-485-1721
Provider Business Practice Location Address Fax Number:
304-424-9424
Provider Enumeration Date:
08/31/2022