Organization
MAIN STREET ADDICTION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH W. SELLS D.O. (OWNER)
(304) 752-3400
Entity
Organization
Contact information
Practice address
204 MAIN ST, LOGAN, WV 25601-3944
(304) 752-3400
(304) 752-3400
Mailing address
204 MAIN ST, LOGAN, WV 25601-3944
(304) 752-3400
(304) 752-3400
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
1489
WV
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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