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Individual

ALEXANDRA DIVITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
STUDENT

Contact information

Practice address
1542 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 696-6035
Mailing address
60 OLDE FARM RD, ONA, WV 25545-9747
(304) 521-8183

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/08/2025
Last updated
01/08/2025
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