Most Relevant Information
Provider Data
| NPI Number: | 1003481185 |
| Provider Name: | JILL DECAVITCH |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/21/2021 |
| Last Updated: | 05/21/2021 |
Provider Practice Location
418 FIR STREET
ELEANOR
WV
25070
Practice Location Phone/Fax
| Phone: | 3043568354 |
| Fax: |
Provider Mailing Location
PO BOX 1190
ELEANOR
WV
250701190
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |