| Organization Name: | WEST VIRGINIA WEIGHT AND WELLNESS |
| NPI Number: | 1043484629 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAMERON DEWAYNE DUFFY (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 37 Veronica Dr Martinsburg |
| State: | WV US |
| Postal Code: | 254043756 |
| Phone Number: | 3042678300 |
| Fax Number: | 3042678301 |
| NPI Enumeration Date: | 04/15/2008 |
| NPI Last Update Date: | 04/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 19195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |