# WETZEL COUNTY COA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053455113
- **Authorized official:** CYNTHIA HALL CULLEY REGISTER NURSE (REGISTER NURSE)
- **Authorized official phone:** (304) 455-3220

## Contact information

- **Practice address:** 145 PADUCAH DR, NEW MARTINSVILLE, WV 26155-2709
- **Practice address phone:** (304) 455-3044
- **Practice address fax:** (304) 455-0280
- **Mailing address:** 145 PADUCAH DR, NEW MARTINSVILLE, WV 26155-2709
- **Mailing address phone:** (304) 455-3044
- **Mailing address fax:** (304) 455-0280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 10363962 | WV | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 02/24/2014