Individual
MRS. CYNTHIA MCILWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 QUARRY AVE, FAIRMONT, WV 26554-4748
(304) 694-6205
Mailing address
317 QUARRY AVE, FAIRMONT, WV 26554-4748
(304) 694-6205
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
2326-7885
WV
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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