Individual
MRS. JAYNE LADIER CANTERBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2869 SENECA TRL S, PETERSTOWN, WV 24963-5037
(304) 753-4336
(304) 772-5553
Mailing address
PO BOX 590, UNION, WV 24983-0590
(304) 772-5555
(304) 772-5553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1562
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00190786
BCBS MOUNTAIN STATE
WV
01
—
00348473
RAILROAD MEDICARE
WV
01
—
172431
UMWA
WV
05
—
1802020000
—
WV
01
—
5004699
AETNA
WV
Enumeration date
05/12/2006
Last updated
01/29/2025
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