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Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
David Lee Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
3100 MACCORKLE AVE SE STE 101, CHARLESTON, WV 25304-1215
(304) 388-8380
Mailing address
415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
(304) 388-7783
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006525
—
WV
Enumeration date
08/01/2006
Last updated
12/14/2009
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