Individual
RAETTA LYNN WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1370 JOHNSON AVE, BRIDGEPORT, WV 26330-1492
(304) 842-7186
(304) 842-2533
Mailing address
1370 JOHNSON AVE, BRIDGEPORT, WV 26330-1492
(304) 842-7186
(305) 842-2533
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00552
WV
Other
Enumeration date
05/14/2010
Last updated
04/21/2022
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