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Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Ryan White Program Grant
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY H. GOODE PT, MBA (PRESIDENT)
(304) 388-7784
Entity
Organization
Contact information
Practice address
3200 MACCORKLE AVE SE, OUTPATIENT CARE CLINIC, CHARLESTON, WV 25304-1227
(304) 388-8909
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7783
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
NULL
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
07/20/2007
Last updated
11/15/2007
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