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Organization

SISSONVILLE HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER RUSSELL (ADMINISTRATIVE ASSISTANT)
(304) 734-2040
Entity
Organization

Contact information

Practice address
7133 SISSONVILLE DR, SISSONVILLE, WV 25320-9738
(304) 734-2040
(304) 734-2047
Mailing address
PO BOX 70, DAWES, WV 25054-0070
(304) 734-2040
(304) 734-2047

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
09/26/2014
Last updated
09/26/2014
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