Greenbrier Valley Urology Associates, INC

NPI #1386630408 in Ronceverte, West Virginia

Provider Information

NPI Number: 1386630408
Entity Type: Organization
Organization Name: Greenbrier Valley Urology Associates, INC
Primary Specialty: Urology
Enumeration Date: Sep 23, 2005
Last Updated: Feb 11, 2014

Practice Location

Address: 119 MAPLEWOOD AVE
City: Ronceverte
State: West Virginia
ZIP Code: 24970-9737
Phone: (304) 647-5642

Authorized Official

Name: KYLE F FORT
Title: MD PRESIDENT
Phone: (304) 647-5642

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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