Individual
LEA BESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1303 WASHINGTON ST W, CHARLESTON, WV 25302-1333
(304) 400-5680
Mailing address
1303 WASHINGTON ST W, CHARLESTON, WV 25302-1333
(304) 400-5680
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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