Organization
EDEN FAMILY PRACTICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY RADCLIFFE (CFO)
(614) 876-9233
Entity
Organization
Contact information
Practice address
313 HUDGINS ST, SUITE 200, LOGAN, WV 25601-3535
(304) 752-9450
Mailing address
3306 BRIDGET DR, COLUMBUS, OH 43221-4431
(614) 876-9233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1939
WV
Other
Enumeration date
05/15/2006
Last updated
08/22/2020
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