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5960 Route 60 East Suite 2 Barboursville WV 25504 | |
| (304) 757-5877 | |
| (304) 757-5878 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 5960 Route 60 East, Barboursville, West Virginia |
| Authorized Official Name and Position | Antonio R Diaz (PRESIDENT) |
| Authorized Official Contact | 3047575877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 907 Barboursville WV 25504 Ph: (304) 757-5877 | 5960 Route 60 East Suite 2 Barboursville WV 25504 Ph: (304) 757-5877 |
| NPI Number | 1881762276 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 03/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881762276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 16814 (West Virginia) | Primary |
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