Most Relevant Information
Provider Data
| NPI Number: | 1003406521 |
| Provider Name: | INDYA K CLEGG |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/19/2021 |
| Last Updated: | 01/19/2021 |
Provider Practice Location
87 SWIERKOS DR
MOUNDSVILLE
WV
260414209
Practice Location Phone/Fax
| Phone: | 3048430910 |
| Fax: |
Provider Mailing Location
100 TURTLE CT
GLEN EASTON
WV
260391572
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |