Individual
LORI MARIE CHAMPAIGN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N 1ST ST, CLARKSBURG, WV 26301-2714
(304) 624-3641
Mailing address
PO BOX 764, CLARKSBURG, WV 26302-0764
(304) 624-3641
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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