Individual
TITI KORBARIYACHIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 BALDWIN ST, APT 9, MORGANTOWN, WV 26505-3251
(304) 376-4691
Mailing address
380 BALDWIN ST, APT 9, MORGANTOWN, WV 26505-3251
(304) 376-4691
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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