Organization
POTOMAC INTEGRATIVE HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DIDDEN (SOLE MEMBER)
(304) 876-2447
Entity
Organization
Contact information
Practice address
51 MADDEX SQUARE DRIVE, SHEPHERDSTOWN, WV 25443-4310
(304) 876-2447
Mailing address
PO BOX 1311, 51 MADDEX SQUARE DRIVE, SHEPHERDSTOWN, WV 25443-1311
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
21679
WV
Other
Enumeration date
04/01/2013
Last updated
04/01/2013
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