Individual
MATTHEW MICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1056 SAINT IVES DR, HURRICANE, WV 25526-9474
(304) 617-2314
Mailing address
1056 SAINT IVES DR, HURRICANE, WV 25526-9474
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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