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Individual

MISTY LEE MEADOWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
(304) 425-1332
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
(304) 425-1332

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01752
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005489001
WV
05
0005489002
WV
Enumeration date
10/03/2013
Last updated
10/03/2013
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