Individual
LARRY WHITEHAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1100 9TH ST STE F, VIENNA, WV 26105-2176
(304) 485-0791
Mailing address
1100 9TH ST STE F, VIENNA, WV 26105-2176
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
05/21/2024
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