Individual
MRS. ALELI RAMISCAL LAMYAITHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
125C MAIN ST, MAN, WV 25635-1211
(304) 583-8808
(304) 583-8809
Mailing address
302 W MCDONALD AVE, MAN, WV 25635-1115
(304) 583-2608
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000793
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001711895
BCBS
WV
05
—
7302248-000
—
WV
Enumeration date
01/29/2007
Last updated
06/07/2010
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