Individual
MS. MIKAELA I POLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
46 N TENNEY DR, BUCKHANNON, WV 26201-8538
(304) 472-0318
Mailing address
RR 2 BOX 154, BUCKHANNON, WV 26201-9519
(304) 460-9038
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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