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NPI Code Detail

MEDICARE: TENILLE WYER

MEDICARE: TENILLE WYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1699369413
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENILLE WYER
Provider Business Mailing Address
First Line : 1843 OWENS AVE
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-3361
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1843 OWENS AVE
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-3361
Country : US
Telephone Number : 304-657-6499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2021
Last Update Date : 02/22/2021

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Directions to “ TENILLE WYER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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