Provider Demographics
NPI:1457488991
Name:WV CENTER FOR PAIN SERVICES
Entity Type:Organization
Organization Name:WV CENTER FOR PAIN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WEIXING
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-561-7879
Mailing Address - Street 1:52 ROANOKE TRCE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1977
Mailing Address - Country:US
Mailing Address - Phone:304-561-7879
Mailing Address - Fax:
Practice Address - Street 1:52 ROANOKE TRCE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-1977
Practice Address - Country:US
Practice Address - Phone:304-561-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain