Individual
HOLLI SANSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
506 HOLLY AVE, LOGAN, WV 25601-3306
(304) 752-1550
Mailing address
PO BOX 388, LORADO, WV 25630-0388
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
92005
WV
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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