Organization
ORTHOCLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK KEITH HALL RTR (OFFICE ADMINISTRATOR)
(304) 766-7515
Entity
Organization
Contact information
Practice address
610 CHESTNUT ST, SOUTH CHARLESTON, WV 25309-1251
(304) 766-7515
(304) 766-7566
Mailing address
610 CHESTNUT ST, SOUTH CHARLESTON, WV 25309-1251
(304) 766-7515
(304) 766-7566
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
12/04/2007
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