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Individual

MRS. COURTNIE DANIELLE SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
529 E MAIN ST, BRIDGEPORT, WV 26330-1824
(304) 842-4202
Mailing address
205 1/2 MILFORD ST, CLARKSBURG, WV 26301-3516

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
WV2009-2554
WV

Other

Enumeration date
07/23/2009
Last updated
07/23/2009
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