Individual
ADA KATHLEEN BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
162 MIDDLETOWN RD, FAIRMONT, WV 26554-8104
(304) 534-7150
(304) 368-9558
Mailing address
162 MIDDLETOWN RD, FAIRMONT, WV 26554-8104
(304) 534-7150
(304) 368-9558
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1093
WV
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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