Individual
MISS ALEXANDRIA GRACE BAISDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 GEORGE ST STE J, BECKLEY, WV 25801-2648
(304) 929-2670
Mailing address
114 BALL ST, BECKLEY, WV 25801-3702
(304) 712-8955
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00201403583
—
WV
Enumeration date
11/12/2020
Last updated
11/12/2020
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