Individual
MILLICENT ROSCENNE ATIENZA MAULEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 E MAIN ST, BUCKHANNON, WV 26201-2909
(304) 473-6802
Mailing address
53 SIOUX DR, BUCKHANNON, WV 26201-1242
(304) 384-0753
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
004162
WV
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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