Individual
INDIA YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-6022
Mailing address
401 LEON DR, FORT ASHBY, WV 26719-9214
(304) 790-9449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
836
WV
Other
Enumeration date
03/15/2021
Last updated
02/29/2024
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