Individual
ELIZABETH MARY CORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
136 SULLIVAN RD, GLEN MORGAN, WV 25813-7600
(304) 256-4555
Mailing address
109 WEST LOCUST DRIVE, BECKLEY, WV 25801
(304) 256-0609
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
695
WV
Other
Enumeration date
06/07/2007
Last updated
10/12/2007
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