Organization
MANCHIN CLINIC SOUTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MANCHIN D.O. (SOLE MEMBER)
(304) 367-9170
Entity
Organization
Contact information
Practice address
181 MIDDLETOWN LOOP, WHITE HALL, WV 26554-8703
(304) 367-9170
(304) 367-9180
Mailing address
181 MIDDLETOWN CIRCLE, FAIRMONT, WV 26554
(304) 367-9170
(304) 367-9180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810011616
—
WV
Enumeration date
04/10/2008
Last updated
07/03/2024
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