# SLEEP TEMPLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114360955
- **Authorized official:** JUSTIN RICHARD WOOD (OWNER)
- **Authorized official phone:** (304) 612-8381

## Contact information

- **Practice address:** RR 2 BOX 369, FAIRMONT, WV 26554-9566
- **Practice address phone:** (304) 612-8381
- **Mailing address:** RR 2 BOX 369, FAIRMONT, WV 26554-9566
- **Mailing address phone:** (304) 612-8381

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2013
- **Last updated:** 04/11/2013