Most Relevant Information
Provider Data
| NPI Number: | 1003496605 |
| Provider Name: | NICOLE COBB |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2021 |
| Last Updated: | 04/09/2021 |
Provider Practice Location
1402 LAKE WASHINGTON RD
WASHINGTON
WV
261818222
Practice Location Phone/Fax
| Phone: | 3046159248 |
| Fax: |
Provider Mailing Location
1402 LAKE WASHINGTON RD
WASHINGTON
WV
261818222
Provider Mailing Phone/Fax
| Phone: | 3046159248 |
| Fax: |