# APPALACHIANWELLNESS CLINIC INC

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

## Provider details

- **NPI number:** 1225526304
- **Authorized official:** MARYAM JAFARY RANA PA-C (PHYSIAN ASSISTANT)
- **Authorized official phone:** (304) 222-5817

## Contact information

- **Practice address:** 425 STANAFORD RD, BECKLEY, WV 25801-3145
- **Practice address phone:** (304) 222-5817
- **Mailing address:** 56 OSPREY RD, BECKLEY, WV 25801-3684
- **Mailing address phone:** (304) 222-5817

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | 1717 | WV | Yes |

## Other

- **Enumeration date:** 04/25/2018
- **Last updated:** 04/12/2023