Individual
KIMBERLY D SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5430 MACCORKLE AVE SE, CHARLESTON, WV 25304-2224
(304) 925-3627
(304) 925-1163
Mailing address
1819 MARTINS BRANCH RD, CHARLESTON, WV 25312-5607
(304) 543-3290
(304) 984-0522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1119197
WV
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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