Individual
CHAZ RODEHEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
309 MEDICAL CT, MARTINSBURG, WV 25401-2843
(304) 598-4835
(304) 598-6873
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(681) 342-2133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2904
WV
Other
Enumeration date
08/18/2022
Last updated
08/09/2024
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