Organization
BOONE PRIMARY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENQING LONG MD (OWNER)
(304) 307-6618
Entity
Organization
Contact information
Practice address
340 STATE ST, MADISON, WV 25130-1365
(304) 307-6618
(304) 307-6619
Mailing address
340 STATE ST, MADISON, WV 25130-1365
(304) 307-6618
(304) 307-6619
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19477
WV
Other
Enumeration date
11/11/2006
Last updated
08/22/2020
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