Individual
TANYA LOUISE ISENHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2907 STATE ST, GASSAWAY, WV 26624-7849
(304) 364-5161
(304) 364-8951
Mailing address
2907 STATE ST, GASSAWAY, WV 26624-7849
(304) 364-5161
(304) 364-8951
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0006079
WV
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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