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Organization
FAIRMONT STATE UNIVERSITY
Active
Organization
FAIRMONT STATE UNIVERSITY
Active
Other names
Fairmont State University Student Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRTA MARTIN PHD (PRESIDENT)
(304) 367-4151
Entity
Organization
Contact information
Practice address
1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
(304) 367-4155
Mailing address
1201 LOCUST AVE FL 3, FAIRMONT, WV 26554-2451
(304) 367-4155
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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