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Organization

WORK CHOICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TODD L METCALF QRP (CHIEF EXECUTIVE OFFICER)
(304) 343-6016
Entity
Organization

Contact information

Practice address
315 WILDWOOD DR, CHARLESTON, WV 25302-3136
(304) 343-6016
(304) 345-7411
Mailing address
315 WILDWOOD DR, CHARLESTON, WV 25302-3136
(304) 343-6016
(304) 345-7411

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
034354
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1029-8295
WV STATE TAX COMMISSIONER
WV
Enumeration date
08/16/2005
Last updated
12/31/2012
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