Individual
MR. HARLEY DAVID SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
1053 2ND AVE, CHARLESTON, WV 25302-1437
(304) 205-3004
Mailing address
1053 2ND AVE, CHARLESTON, WV 25302-1437
(304) 205-3004
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WV
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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