Healthcare Provider Details

I. General information

NPI: 1588656680
Provider Name (Legal Business Name): WORK CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WILDWOOD DR
CHARLESTON WV
25302-3136
US

IV. Provider business mailing address

315 WILDWOOD DR
CHARLESTON WV
25302-3136
US

V. Phone/Fax

Practice location:
  • Phone: 304-343-6016
  • Fax: 304-345-7411
Mailing address:
  • Phone: 304-343-6016
  • Fax: 304-345-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number034354
License Number StateWV

VIII. Authorized Official

Name: MR. TODD L METCALF
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: QRP
Phone: 304-343-6016