Individual
MARY KELSEY FAUTEUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
3199 CORE RD, PARKERSBURG, WV 26104-1557
(304) 485-5185
(304) 485-0051
Mailing address
3199 CORE RD, 3194 CORE RD, PARKERSBURG, WV 26104-1557
(304) 485-5185
(304) 485-0051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1043744
WV
Other
Enumeration date
08/31/2006
Last updated
10/19/2011
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