Individual
TIMOTHY DEAN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9344 SHOESTRING TRL, WILLIAMSBURG, WV 24991-0141
(304) 661-2336
Mailing address
PO BOX 141, WILLIAMSBURG, WV 24991-0141
(304) 667-6678
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
EMP4738
WV
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
10/06/2022
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