Organization
COALL INC
Active
Other names
Rejuv
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M HOLEHOUSE MD (OWNER)
(304) 363-9600
Entity
Organization
Contact information
Practice address
74 ROXBURY RD, FAIRMONT, WV 26554-8223
(304) 363-9600
(304) 363-9601
Mailing address
74 ROXBURY RD, FAIRMONT, WV 26554-8223
(304) 363-9600
(304) 363-9601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15258
WV
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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