Individual
CHELSEA LASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 MACCORKLE AVE SE, CHARLESTON, WV 25314-1197
(304) 343-4300
Mailing address
208 MACCORKLE AVE SE, CHARLESTON, WV 25314-1197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2733
WV
Other
Enumeration date
01/10/2022
Last updated
07/24/2023
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