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Organization

VIDYA P PURANIK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GENEVA L LYNCH (OFFICE MANAGER)
(304) 253-5793
Entity
Organization

Contact information

Practice address
250 STANAFORD RD, SUITE ONE, BECKLEY, WV 25801-3140
(304) 253-5793
(304) 253-0166
Mailing address
PO BOX 787, CRAB ORCHARD, WV 25827-0787
(304) 253-5793
(304) 253-0166

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
08/14/2008
Last updated
08/26/2008
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