Individual
ALVIN DALE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
641 BOSLEY RD, KEYSER, WV 26726-7465
(304) 813-5441
Mailing address
116 MILL MEADOW LOOP, KEYSER, WV 26726-9145
(304) 790-3538
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
WV
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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