Organization
INTEGRATED HEALTH CARE PROVIDERS, INC
Active
Other names
Sports Medicine & Rehab Center Cross Lanes
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY H. GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
130 GOFF MOUNTAIN RD, CROSS LANES, WV 25313-1419
(304) 388-7055
(304) 388-7058
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006518
—
WV
Enumeration date
07/19/2006
Last updated
04/21/2009
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