Individual
BERNICE KEESUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
749 HIDDEN VALLEY RD, JANE LEW, WV 26378-6996
(304) 884-7835
Mailing address
749 HIDDEN VALLEY RD, JANE LEW, WV 26378-6996
(304) 884-7835
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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