Individual
COREY MIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS/CM
Contact information
Practice address
111 19TH ST, WHEELING, WV 26003-3709
(304) 234-3500
Mailing address
111 19TH STREET P.O. BOX 6400, WHEELING, WV 26003-2525
(412) 605-4443
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
02/17/2022
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