Individual
TESSIE R IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1075 VAN VOORHIS RD, SUITE 100, MORGANTOWN, WV 26505-3586
(304) 599-2273
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-7401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01546
WV
Other
Enumeration date
02/22/2011
Last updated
04/01/2011
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