Individual
TESSA RAE CAVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 GRAND CENTRAL AVE, VIENNA, WV 26105-1347
(304) 295-4573
(304) 295-0639
Mailing address
2300 GRAND CENTRAL AVE, VIENNA, WV 26105-1347
(304) 295-4573
(304) 295-0639
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0012152
WV
Other
Enumeration date
10/04/2020
Last updated
03/12/2024
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