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Individual

MAVIS JEAN BLEIGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15 BANK ST, CLAY, WV 25043
(304) 587-9992
(304) 587-9993
Mailing address
25 SUNDANCE RD, IVYDALE, WV 25113-8164
(304) 968-9002

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
11/23/2020
Last updated
12/03/2020
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