Individual
KASSI MARIE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 ADAIR ST, BECKLEY, WV 25801-3733
(304) 960-2077
Mailing address
126 FOX RUN RD, BECKLEY, WV 25801-9403
(304) 960-2077
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
75033
WV
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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