Individual
IDA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 GROVE AVE, RONCEVERTE, WV 24970-1345
(681) 318-9159
Mailing address
165 GROVE AVE, RONCEVERTE, WV 24970-1345
(681) 318-9159
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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