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149 Jerry West Hwy Ste 2a Logan WV 25601-3967 | |
| (304) 688-2373 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 149 Jerry West Hwy Ste 2a, Logan, West Virginia |
| Authorized Official Name and Position | Julie Walls (OWNER) |
| Authorized Official Contact | 3046882373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 145 Verner WV 25650-0145 Ph: (304) 688-2373 | 149 Jerry West Hwy Ste 2a Logan WV 25601-3967 Ph: (304) 688-2373 |
| NPI Number | 1043817471 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 01/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043817471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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