Individual
MATTHEW MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
198 WOODRUM LN, WEST COLUMBIA, WV 25287-9723
(304) 593-5913
Mailing address
RT 2 BOX 94C, LEON, WV 25123
(304) 593-5913
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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