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Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Facial Surgery Center II
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
830 PENNSYLVANIA AVE STE 302, CHARLESTON, WV 25302-3390
(304) 388-2950
(304) 388-2951
Mailing address
415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
08/01/2006
Last updated
11/15/2007
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