Individual
GLENN GAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 EDISON ST, NUTTER FORT, WV 26301-4417
(304) 626-3204
Mailing address
117 EDISON ST, NUTTER FORT, WV 26301-4417
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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