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Individual

MS. MARY BETH LICHTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
341 SPRUCE ST, MORGANTOWN, WV 26505-5504
(304) 292-8234
(304) 284-0133
Mailing address
3 WEAVER TOWN HOMES, MORGANTOWN, WV 26501-2251
(304) 906-5965

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9103568
FL
363AM0700X
Medical Physician Assistant
Primary
01384
WV

Other

Enumeration date
11/15/2006
Last updated
12/10/2008
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