Individual
ADAM STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WV
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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