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>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1245204015

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
Tel: 304-358-2355  Fax: --

Contact information for business:
PO BOX 100  FRANKLIN, WV 26807-0100 US
Tel: 304-358-2355  Fax: 304-358-3054

Registration Information:
NPI: 1245204015
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine

Legacy codes, insurance codes and state license numbers:

MS BCBS001718817WV01


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