Healthcare Provider Details

I. General information

NPI: 1295656635
Provider Name (Legal Business Name): JACE RILEY MCHALE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 HIGH ST UNIT A
MORGANTOWN WV
26505-7501
US

IV. Provider business mailing address

301 SCOTT AVE
MORGANTOWN WV
26508-8804
US

V. Phone/Fax

Practice location:
  • Phone: 304-296-1731
  • Fax:
Mailing address:
  • Phone: 304-296-1731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: