Individual
ERICA WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
OLD MIDLAND TRAIL-RT 60, ANSTED, WV 25812
(304) 658-5271
Mailing address
HC 66 BOX 125C, HICO, WV 25854-9719
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1536
WV
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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