Individual
MR. COLTEN RAY SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1538 CHARLESTON AVE, HUNTINGTON, WV 25701
(000) 000-0000
Mailing address
1538 CHARLESTON AVE, HUNTINGTON, WV 25701
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IN0009784
WV
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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