Organization
WETZEL COUNTY COA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA HALL CULLEY REGISTER NURSE (REGISTER NURSE)
(304) 455-3220
Entity
Organization
Contact information
Practice address
145 PADUCAH DR, NEW MARTINSVILLE, WV 26155-2709
(304) 455-3044
(304) 455-0280
Mailing address
145 PADUCAH DR, NEW MARTINSVILLE, WV 26155-2709
(304) 455-3044
(304) 455-0280
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
10363962
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030804000
—
WV
05
—
0030804001
—
WV
05
—
0030804002
—
WV
Enumeration date
02/20/2007
Last updated
02/24/2014
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