Individual
RYAN SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2065 MAIN ST, LUMBERPORT, WV 26386-8070
(681) 253-1613
Mailing address
2065 MAIN ST, LUMBERPORT, WV 26386-8070
(681) 253-1613
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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