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Individual

CAROL M. KISNER MCGRAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
26 COMMERCE DRIVE, WESTOVER, WV 26501
(304) 241-1219
(304) 322-4485
Mailing address
105 MAPLE GROVE AVE, WESTOVER, WV 26501-4081
(304) 241-1219
(304) 322-4485

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
886
WV
225X00000X
Occupational Therapist
OC007261L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1802136000
WV
Enumeration date
06/05/2009
Last updated
10/19/2017
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