Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Urology Center of Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF H. GOODE PT, MBA (ADMINISTRATIVE COORDINATOR)
(304) 388-7783
Entity
Organization
Contact information
Practice address
1201 WASHINGTON ST E, SUITE 105, CHARLESTON, WV 25301-1834
(304) 388-1965
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7783
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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