Individual
KWANTIA RAYN OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 MOUNTAIN PARK DR, FAIRMONT, WV 26554-8992
(304) 816-3687
Mailing address
16 MOUNTAIN PARK DR, FAIRMONT, WV 26554-8992
(304) 816-3687
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
WV
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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