Individual
GINA RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 QUINCY ST APT 210, FAIRMONT, WV 26554-5302
(304) 694-2193
Mailing address
401 QUINCY ST APT 210, FAIRMONT, WV 26554-5302
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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