| NPI | 1982604997 |
|---|---|
| Other Name | MOUNTAIN STATE ENT AND FACIAL PLASTIC SURGERY |
| Other Name | MOUNTAIN STATE ENT |
| Entity Type | Organization |
| Authorized Contact | ALBERT JAMES PAINE Owner; President 304-255-2341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WV 006769) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2024-03-29 |