# ST. ALBANS INTEGRATIVE HEALTH CENTER

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

## Provider details

- **NPI number:** 1417249459
- **Authorized official:** MR. RUDOLPH MICHAEL KEVAK JR. M.D. (OWNER)
- **Authorized official phone:** (304) 201-3600

## Contact information

- **Practice address:** 200 MAIN ST, SAINT ALBANS, WV 25177-2802
- **Practice address phone:** (304) 201-3600
- **Practice address fax:** (304) 201-2368
- **Mailing address:** 552 BOX, ST. ALBANS, WV 25177
- **Mailing address phone:** (304) 201-3600
- **Mailing address fax:** (304) 201-2368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 18688 | WV | Yes |

## Other

- **Enumeration date:** 05/10/2011
- **Last updated:** 05/10/2011