Individual
RAMONA B LACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
(304) 598-6900
(304) 293-6963
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
(304) 329-1175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
00258
WV
363AM0700X
Medical Physician Assistant
Primary
258
WV
Other
Enumeration date
08/31/2006
Last updated
08/11/2016
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