Individual
MARY ANNE DUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3201 GRAND CENTRAL AVE, VIENNA, WV 26105-1539
(304) 295-9594
Mailing address
4701 6TH AVE, VIENNA, WV 26105-3003
(304) 295-8371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001017
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002106000
—
WV
Enumeration date
03/30/2007
Last updated
03/14/2016
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