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General NPI Number Information
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NPI Number | 1821700162
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Entity Type | Organization
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Legal Business Name | SPAY NEUTER INCENTIVE PROGRAM OF WEST VIRGINIA
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 1470 EARL L CORE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-5884
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Country | US
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Telephone | 904-386-5937
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Fax |
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Provider Business Mailing Address
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Address Line | 975 GREENTREE DR
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City | WINTER PARK
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State | FL
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Zip | 32789-2787
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Country | US
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Telephone | 904-386-5937
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Fax |
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | CARRIE CURTIS
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Credential |
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Telephone | 904-386-5937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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