Organization
NEUROLOGY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE L. MILEY (MANAGER)
(304) 645-5185
Entity
Organization
Contact information
Practice address
100 TAYLOR LN, RONCEVERTE, WV 24970-1337
(304) 645-5185
(904) 645-5184
Mailing address
PO BOX 1670, LEWISBURG, WV 24901-4670
(304) 645-5185
(904) 645-5184
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
21743
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC7262
PALMETTO GBA
—
Enumeration date
08/23/2007
Last updated
01/28/2008
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