Individual
TEQUILA GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 MARSHALL ST, MCMECHEN, WV 26040-1146
(304) 281-6511
Mailing address
1315 MARSHALL ST, MCMECHEN, WV 26040-1146
(304) 281-6511
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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