Organization
PEDIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA R BLOSSER M.D. (PARTNER)
(304) 243-1250
Entity
Organization
Contact information
Practice address
30 MEDICAL PARK, STE 202, WHEELING, WV 26003-6391
(304) 243-1250
(304) 243-1518
Mailing address
30 MEDICAL PARK, STE 202, WHEELING, WV 26003-6391
(304) 243-1250
(304) 243-1518
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291U00000X
TAXONOMY CODE
WV
05
—
3810001840
—
WV
Enumeration date
10/17/2007
Last updated
10/17/2007
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