Individual
JINI PAUL MATTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9300
(304) 429-6755
Mailing address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9300
(304) 429-6755
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-1-26006
OH
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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