Individual
MRS. LORI JANE RAINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
401 DIVISION ST STE 306, SOUTH CHARLESTON, WV 25309-1455
(304) 766-4300
Mailing address
110 MONTEREY LN, CROSS LANES, WV 25313-2600
(304) 776-3638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00976
WV
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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