Healthcare Provider Details

I. General information

NPI: 1326467333
Provider Name (Legal Business Name): ZACHARY FRANCIS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 12TH STREET EXT
PRINCETON WV
24740-2329
US

IV. Provider business mailing address

200 12TH STREET EXT
PRINCETON WV
24740-2329
US

V. Phone/Fax

Practice location:
  • Phone: 304-425-9541
  • Fax: 304-487-6199
Mailing address:
  • Phone: 304-425-9541
  • Fax: 304-487-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSW3141350
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: