Individual
CARL TANNER SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
195 MARGARET ST, BANCROFT, WV 25011
(304) 964-3519
Mailing address
PO BOX 349, BANCROFT, WV 25011-0349
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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