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Individual

FONDA GLANVILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
2546 MCCOMAS RD APT 2, BARBOURSVILLE, WV 25504-8757
(304) 730-5668
Mailing address
2546 MCCOMAS RD APT 2, BARBOURSVILLE, WV 25504-8757

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
121168
WV

Other

Enumeration date
11/07/2024
Last updated
11/07/2024
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