| Equinox Llc | |
|
705 Washington St Ravenswood WV 26164-1729 | |
| (304) 868-6000 | |
| (304) 868-6002 |
| Full Name | Equinox Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 705 Washington St, Ravenswood, West Virginia |
| Authorized Official Name and Position | Richard J. Blackburn (PRESIDENT) |
| Authorized Official Contact | 3048686000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Equinox Llc 705 Washington St Ravenswood WV 26164-1729 Ph: (304) 868-6000 | Equinox Llc 705 Washington St Ravenswood WV 26164-1729 Ph: (304) 868-6000 |
| NPI Number | 1942407465 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 10/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942407465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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