Individual
MRS. MARY JUNE IBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
900 VIRGINIA ST. EAST SUITE 500 MAXIM HEALTHCARE, CHARLESTON, WV 25301
(681) 313-4759
Mailing address
104 PROCESS RD., HEDGEVILLE, WV 25427
(301) 471-7885
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP-14881
MD
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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