Individual
KATELYNN DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
428 W MARTIN ST, MARTINSBURG, WV 25401-2747
(681) 260-0818
Mailing address
428 W MARTIN ST, MARTINSBURG, WV 25401-2747
(681) 260-0818
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00700024108
—
WV
Enumeration date
03/03/2017
Last updated
03/03/2017
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