Individual
MATTHEW PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Mailing address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-20-1119
WV
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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