Individual
ROBERT KELLY MASSIE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 MARKET STREET, PETERSTOWN, WV 24963
(304) 753-5074
(304) 753-5078
Mailing address
PO BOX 338, PETERSTOWN, WV 24963-0338
(304) 753-5074
(304) 753-5078
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0004036
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141778000
—
WV
Enumeration date
10/05/2006
Last updated
06/13/2008
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