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General NPI Number Information
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NPI Number | 1689912214
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Entity Type | Organization
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Legal Business Name | WEST VIRGINIA SLEEP CENTERS
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 24 MALLARD CT
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City | BECKLEY
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State | WV
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Zip | 25801-3664
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Country | US
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Telephone | 304-254-9861
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Fax |
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Provider Business Mailing Address
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Address Line | 24 MALLARD CT
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City | BECKLEY
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State | WV
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Zip | 25801-3664
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Country | US
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Telephone | 304-253-5420
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Fax | 681-238-5707
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TRACY JOHNSON
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Credential | LSW
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Telephone | 304-252-8409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State | WV
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