Organization
TWIN STATES FAMILY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYNALDO JOSE MD (OWNER)
(304) 248-8096
Entity
Organization
Contact information
Practice address
HIGHWAY 102, WOLFE, WV 24751
(304) 248-8096
(304) 248-8096
Mailing address
PO BOX 19, NEMOURS, WV 24738-0019
(304) 248-8096
(304) 248-8096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11738WV
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0048928000
—
WV
Enumeration date
09/27/2006
Last updated
04/20/2008
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