Individual
CLINTON ROGER KITZMILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 TECHNOLOGY DR, FAIRMONT, WV 26554-8824
(304) 292-2108
Mailing address
1000 TECHNOLOGY DR, FAIRMONT, WV 26554-8824
(301) 379-1580
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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