Individual
LACY VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4124 MCCLELLAN HWY, BRANCHLAND, WV 25506-8717
(681) 888-3157
Mailing address
4124 MCCLELLAN HWY, BRANCHLAND, WV 25506-8717
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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