| Organization Name: | SLEEP TEMPLE |
| NPI Number: | 1114360955 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN RICHARD WOOD (OWNER) |
| Mailing Address: | Rr 2 Box 369 Fairmont |
| State: | WV US |
| Postal Code: | 265549566 |
| Phone Number: | 3046128381 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2013 |
| NPI Last Update Date: | 04/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |