Individual
KENNETH MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
655 HUFF YOUNG RD, LOST CREEK, WV 26385-7673
(304) 745-5504
Mailing address
655 HUFF YOUNG RD, LOST CREEK, WV 26385-7673
(304) 745-5504
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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