Organization
THE TRAINING ROOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM A BOLESTA BOC ATC (PRESIDENT)
(410) 374-4000
Entity
Organization
Contact information
Practice address
20 HOSPITAL DR, DOCTORS PARK, LOGAN, WV 25601-3452
(410) 374-4000
(410) 374-5000
Mailing address
PO BOX 611, HAMPSTEAD, MD 21074-0611
(410) 374-4000
(410) 374-5000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2216-3400
WV
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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