Individual
MADISON LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4527
Mailing address
70859 COLERAIN RD, BRIDGEPORT, OH 43912-9772
(704) 827-5774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
109502
WV
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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