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Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Facial Surgery Center I
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
415 MORRIS ST STE 309, CHARLESTON, WV 25301-1853
(304) 388-3290
(304) 388-3186
Mailing address
415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
(304) 388-7783
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
08/04/2006
Last updated
11/15/2007
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