Most Relevant Information
Provider Data
NPI Number: | 1003538745 |
Provider Name: | MICHAILA ICYLENE MCANUFF |
Entity Type: | Individual |
Taxonomy Code: | 3747P1801X |
Specialty: | Technician |
License Number: |
Most Important Dates
Enumeration Date: | 09/19/2022 |
Last Updated: | 09/19/2022 |
Provider Practice Location
716 COLONY DR
CHARLESTON
WV
253141790
Practice Location Phone/Fax
Phone: | 9296772355 |
Fax: |
Provider Mailing Location
716 COLONY DR
CHARLESTON
WV
253141790
Provider Mailing Phone/Fax
Phone: | 9296772355 |
Fax: |