Most Relevant Information
Provider Data
| NPI Number: | 1003416777 |
| Provider Name: | CAROLYN LEE MORAN |
| Entity Type: | Individual |
| Taxonomy Code: | 376J00000X |
| Specialty: | Homemaker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2020 |
| Last Updated: | 10/30/2020 |
Provider Practice Location
1614 S KANAWHA ST
BECKLEY
WV
258016239
Practice Location Phone/Fax
| Phone: | 3042551397 |
| Fax: |
Provider Mailing Location
1614 S KANAWHA ST
BECKLEY
WV
258016239
Provider Mailing Phone/Fax
| Phone: | 3042551397 |
| Fax: |