Individual
KATHERYN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CASE WV, 600 TRENT STREET, PRINCETON, WV 24701
(304) 425-7111
Mailing address
355 BLUEFIELD AVE, BLUEFIELD, WV 24701-2883
(304) 425-7111
(304) 425-1138
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
1568796027
WV
3747P1801X
Personal Care Attendant
1568796027
WV
Other
Enumeration date
08/29/2023
Last updated
10/25/2023
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