Organization
FAMILY MEDICAL CLINIC OF JANE LEW ( LAB)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIE SWISHER (OFFICE MANAGER)
(304) 884-7880
Entity
Organization
Contact information
Practice address
134 INDUSTRIAL PARK RD, JANE LEW, WV 26378
(304) 884-7880
Mailing address
134 INDUSTRIAL PARK RD, SUITE 200, JANE LEW, WV 26378
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6702003000
—
WV
Enumeration date
10/31/2006
Last updated
08/12/2008
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