Individual
EVAN NUZUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1519 JANES HILL RD, SHINNSTON, WV 26431-7139
(304) 669-2122
Mailing address
1519 JANES HILL RD, SHINNSTON, WV 26431-7139
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001961
WV
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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