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Organization

WILLOW RIDGE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RHONDA LYNETTE HAMM DO (OWNER/PHYSICIAN)
(304) 645-7503
Entity
Organization

Contact information

Practice address
333 N JEFFERSON ST, LEWISBURG, WV 24901-1116
(304) 645-7503
(304) 645-7582
Mailing address
333 N JEFFERSON ST, LEWISBURG, WV 24901-1116
(304) 645-7503
(304) 645-7582

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810001633
WV
Enumeration date
04/09/2008
Last updated
07/09/2008
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