Organization
APPALACHIANWELLNESS CLINIC INC
Active
Organization
APPALACHIANWELLNESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYAM JAFARY RANA PA-C (PHYSICIAN ASSISTANT)
(304) 222-5817
Entity
Organization
Contact information
Practice address
425 STANAFORD RD, BECKLEY, WV 25801-3145
(304) 222-5817
Mailing address
56 OSPREY RD, BECKLEY, WV 25801-3684
(304) 222-5817
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
12/04/2017
Last updated
03/24/2023
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