Icp West Virginia LLC
NPI #1134698798 in Bluefield, West Virginia
Provider Information
- NPI Number
- 1134698798
- Entity Type
- Organization
- Organization Name
- Icp West Virginia LLC
- Primary Specialty
- Emergency Medicine
- Enumeration Date
- Nov 13, 2018
- Last Updated
- Nov 13, 2018
Practice Location
- Address
- 500 CHERRY ST
- City
- Bluefield
- State
- West Virginia
- ZIP Code
- 24701-3306
- Phone
- (304) 327-1100
Authorized Official
- Name
- MATTHEW JACKSON
- Title
- AUTHORIZED OFFICIAL
- Phone
- (813) 746-3993
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medicine |
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