Individual
MARY NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
(304) 231-3820
Mailing address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
29461
WV
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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