Individual
JERRY I HADRYCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
603 ALTA VISTA AVE, FAIRMONT, WV 26554-4185
(304) 333-3338
(304) 333-3201
Mailing address
603 ALTA VISTA AVE, FAIRMONT, WV 26554-4185
(304) 333-3338
(304) 333-3201
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
320
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099983000
—
WV
05
—
01623405
—
PA
01
—
WV00320
STATE
WV
Enumeration date
08/23/2005
Last updated
04/17/2025
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