Individual
JOHNNA SHAY HARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 E MAIN ST, MANNINGTON, WV 26582-1259
(304) 815-2165
Mailing address
8592 N FORK RD, PINE GROVE, WV 26419-8361
(304) 815-2165
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0005775
WV
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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