Organization
RENEE'S BIRKENSTOCK PARKERSBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN LOUISE PAXTON (MEMBER)
(304) 865-2315
Entity
Organization
Contact information
Practice address
1500 GRAND CENTRAL AVE, SUITE 106A, VIENNA, WV 26105-1079
(304) 865-2315
(304) 428-6142
Mailing address
1500 GRAND CENTRAL AVE, SUITE 106A, VIENNA, WV 26105-1079
(304) 865-2315
(304) 428-6142
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
809506
WV
Other
Enumeration date
08/31/2008
Last updated
11/17/2008
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