Individual
MRS. MARLENE RAE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT, ASCP
Contact information
Practice address
4898 BACKUS RD, MEADOW BRIDGE, WV 25976-9751
(304) 255-4926
Mailing address
4898 BACKUS RD, MEADOW BRIDGE, WV 25976-9751
(304) 255-4926
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
1601
WV
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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