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: |