Individual
DONNA SUE PEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
69 AVENUE B, MADISON, WV 25130-1162
(304) 369-3131
(304) 369-6789
Mailing address
501 22ND ST, DUNBAR, WV 25064-1711
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
21558
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0161636000
—
WV
Enumeration date
03/07/2008
Last updated
03/07/2008
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