Individual
GINA LYNN FONDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
130 FONDALE ST, BECKLEY, WV 25801-3502
(304) 573-8154
Mailing address
130 FONDALE ST, BECKLEY, WV 25801-3502
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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