Individual
JEREMY WILSON DYAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 E 2ND AVE, WILLIAMSON, WV 25661-3602
(304) 236-4247
Mailing address
RR 3 BOX 609, DELBARTON, WV 25670-9799
(304) 475-2312
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2009-2532
WV
Other
Enumeration date
07/30/2009
Last updated
07/31/2009
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