| Organization Name: | BECKLEY PAIN CLINIC |
| NPI Number: | 1033518097 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA LYNN MCGRAW (FAMILY NURSE PRACTITIONER) |
| Mailing Address: | 1902 Harper Rd Beckley |
| State: | WV US |
| Postal Code: | 258012642 |
| Phone Number: | 3048948817 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2014 |
| NPI Last Update Date: | 08/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 41174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |