Individual
JOHN RABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
471 MAIN ST STE B, MADISON, WV 25130-1223
(304) 307-6005
(304) 307-6038
Mailing address
9083 DANIEL BOONE PKWY, FOSTER, WV 25081-6037
(304) 369-0550
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
AP00942085
WV
Other
Enumeration date
09/22/2020
Last updated
10/05/2020
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