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Organization
CABIN CREEK HEALTH CENTER INC.
Active
Organization
CABIN CREEK HEALTH CENTER INC.
Active
Other names
Kanawha City Health Center Lab
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RUSSELL (ADMINISTRATIVE ASSISTANT)
(304) 734-2040
Entity
Organization
Contact information
Practice address
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304-1848
(304) 734-2040
(304) 734-2047
Mailing address
PO BOX 70, DAWES, WV 25054-0070
(304) 734-2040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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