Individual
SUMMER GUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 13TH ST, DUNBAR, WV 25064-3015
(304) 553-1055
(304) 397-4019
Mailing address
PO BOX 178, HURRICANE, WV 25526-0178
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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