Individual
KAYNELL TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
138 PARK PLACE, CLINTWOOD, VA 24228
(276) 926-1684
(276) 926-6070
Mailing address
1348 FOX TOWN RD, CLINTWOOD, VA 24228-7006
(276) 926-8603
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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