Individual
KANDIE L LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 JUMP ST, MONTANA MINES, WV 26586-2706
(681) 404-1571
Mailing address
102 JUMP ST, MONTANA MINES, WV 26586-2706
(681) 404-1571
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41793
WV
Other
Enumeration date
07/03/2026
Last updated
07/03/2026
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