| Deluca Family Wellness Center, Inc. | |
|
Rt. 2 Box 406 Suite 121 Clarksburg WV 26301 | |
| (304) 626-3541 | |
| (304) 626-3174 |
| Full Name | Deluca Family Wellness Center, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | Rt. 2 Box 406 Suite 121, Clarksburg, West Virginia |
| Authorized Official Name and Position | Matthew Joseph Deluca (MANAGING MEMBER) |
| Authorized Official Contact | 3046263541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deluca Family Wellness Center, Inc. Rt. 2 Box 406 Suite 121 Clarksburg WV 26301 Ph: (304) 626-3541 | Deluca Family Wellness Center, Inc. Rt. 2 Box 406 Suite 121 Clarksburg WV 26301 Ph: (304) 626-3541 |
| NPI Number | 1174729990 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 01/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174729990 | NPI | - | NPPES |
| 1540 | Other | WV | WV LPC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1540 (West Virginia) | Primary |
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