is a Specialist in Morgantown, . practices all healthcare services and medical treatments related to Specialist. The NPI Number for is 1275584872. The last update date is .
's current location address is 3496 University Ave, Morgantown, . You can contact this provider via phone number 3045997075 and fax number 3045816800. The mailing address for is 3496 University Ave, Morgantown, . To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 3496 University Ave, Morgantown, |
Phone Number | 3045997075 |
Fax Number | 3045816800 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1275584872 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 3496 University Ave |
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City | Morgantown |
State | (WV) |
Post Code | 265053001 |
Phone Number | 3045997075 |
Fax Number | 3045816800 |
Provider's Primary Taxonomy Detail
Speciality | Specialist |
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Taxonomy | 174400000X |
Licence No | 20147 |
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
6200220000 | WV | -- |
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