Individual
AMY AXLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 TOWER RD, ELIZABETH, WV 26143-7177
(304) 966-8913
Mailing address
255 TOWER RD, ELIZABETH, WV 26143-7177
(304) 966-8913
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-931
WV
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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