Organization
INTEGRATED HEALTH CARE PROVIDERS, INC.
Active
Other names
Plastic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOODE PT, MBA (PRESIDENT)
(304) 388-7783
Entity
Organization
Contact information
Practice address
210 BROOKS ST STE 200, CHARLESTON, WV 25301-1848
(304) 388-1930
Mailing address
415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
(304) 388-7783
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006520
—
WV
Enumeration date
08/02/2006
Last updated
11/15/2007
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