Individual
IVY LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
837 CHILDERS RUN RD, BUCKHANNON, WV 26201-9658
(304) 997-3608
Mailing address
837 CHILDERS RUN RD, BUCKHANNON, WV 26201-9658
(304) 997-3608
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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