Individual
MARK CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
137 8TH AVE W, HUNTINGTON, WV 25701-2510
(304) 523-4673
Mailing address
1004 CLUB DR, WASHINGTON, WV 26181-6307
(304) 615-1091
(304) 615-1091
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
26-980SUD
WV
Other
Enumeration date
07/22/2026
Last updated
07/22/2026
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