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Individual

LESLIE UTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1313 LOCUST AVE, FAIRMONT, WV 26554-0072
(304) 366-4750
Mailing address
1313 LOCUST AVE, FAIRMONT, WV 26554-0072
(304) 366-4750

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
3747P1801X
Personal Care Attendant

Other

Enumeration date
05/11/2022
Last updated
05/11/2022
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