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1144563412
MD2U WEST VIRGINIA LLC
CHARLESTON, WV
NPI
1144563412
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Entity Type
Organization
Authorized Contact
GREGORY DAVID LATTA
CIO
502-416-1851
Organization Subpart ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2013-04-04
Last Update Date
2013-04-04
Business Address
MD2U WEST VIRGINIA LLC
3501 MACCORKLE AVE SE # 151
CHARLESTON, WV 25304-1419
Phone number: 502-327-9100
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Mailing Address
MD2U WEST VIRGINIA LLC
140 WHITTINGTON PKWY STE 100
LOUISVILLE, KY 40222-4930
Phone number: 502-327-9100
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