Organization
COUNTRY ROADS HOUSECALLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA SMITH FNP-BC (NURSE PRACTITIONER)
(304) 685-1901
Entity
Organization
Contact information
Practice address
112 QUARTERHORSE DR, SCOTT DEPOT, WV 25560-9684
(304) 685-1901
Mailing address
112 QUARTERHORSE DR, SCOTT DEPOT, WV 25560-9684
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
04/29/2021
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