Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
David Lee Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
3100 MACCORKLE AVE SE STE 101, CHARLESTON, WV 25304-1215
(304) 388-8380
Mailing address
415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
(304) 388-7783
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006525
—
WV
Enumeration date
08/01/2006
Last updated
12/14/2009
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