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Four Seasons Family Practice

Family Medicine in Princeton, WV. Organization (NPI-2).

NPI number1750497145
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1750497145
Entity type
Organization (NPI-2)
Legal business name
Four Seasons Family Practice
Organization subpart
No
Enumeration date
Aug 21, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine16854WVYes

Practice location

904 Harrison St
Princeton, WV 24740-3011

Phone 304-431-7100 · Fax 304-431-7112

Mailing address

Po Box 1050
Princeton, WV 24740-1050

Phone 304-431-7100 · Fax 304-431-7112

Authorized official

Nancy A Lohuis
Physician/Owner
3044317100

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