Individual
LYDIA BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 STANAFORD RD, BECKLEY, WV 25801-3143
(304) 252-6317
Mailing address
149 MAPLEWOOD RD, LESTER, WV 25865-9580
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001607
WV
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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