Individual
AVERIAL MADONNA PORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
124 SKEMP AVE, MORGANTOWN, WV 26505-6333
(304) 376-2460
Mailing address
124 SKEMP AVE, MORGANTOWN, WV 26505-6333
(304) 376-2460
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0007917
WV
183500000X
Pharmacist
03132419
OH
183500000X
Pharmacist
447251
PA
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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