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11713 Route 152 Ste 1 Wayne WV 25570-6539 | |
(304) 523-1142 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 11713 Route 152 Ste 1, Wayne, West Virginia |
Authorized Official Name and Position | Julie D Ray (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 3045231142 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5044 Newcomb Creek Rd Huntington WV 25704-9704 Ph: (304) 638-8329 | 11713 Route 152 Ste 1 Wayne WV 25570-6539 Ph: (304) 523-1142 |
NPI Number | 1720863699 |
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Provider Enumeration Date | 08/29/2023 |
Last Update Date | 02/16/2024 |
Identifier | Type | State | Issuer |
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1720863699 | NPI | - | NPPES |