Individual
ANTHONY J DECARLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 PENNSYLVANIA AVE STE C, CHARLESTON, WV 25302-4835
(304) 965-9081
(304) 346-1860
Mailing address
248 BURGESS DR, CHARLESTON, WV 25312-8143
(304) 932-6743
(304) 471-2488
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
48239
WV
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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