Most Relevant Information
Provider Data
| NPI Number: | 1003503541 |
| Provider Name: | STORMY JO LAWLESS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/24/2023 |
| Last Updated: | 04/24/2023 |
Provider Practice Location
695 MOUNTAINEER HWY
MULLENS
WV
258820255
Practice Location Phone/Fax
| Phone: | 3042948800 |
| Fax: |
Provider Mailing Location
695 MOUNTAINEER HWY
MULLENS
WV
258820255
Provider Mailing Phone/Fax
| Phone: | 3042948800 |
| Fax: |