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Organization

ST OF WV DIV OF REHABILITATION SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LAINE WILDER (ASSISTANT DIRECTOR, CENTER ADMINIST)
(304) 766-4767
Entity
Organization

Contact information

Practice address
BARRON DRIVE, INSTITUTE, WV 25112-1004
(304) 766-4848
(304) 766-4937
Mailing address
PO BOX 1004, INSTITUTE, WV 25112-1004
(304) 766-4848
(304) 766-4937

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
NA GOV'T OWNED
WV

Other

Enumeration date
11/30/2005
Last updated
08/22/2020
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