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1003932914
CANDACE LEIGH LUSK
LOGAN, WV
NPI
1003932914
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: WV 1381)
Enumeration Date
2007-03-22
Last Update Date
2007-07-08
Business Address
Mrs. CANDACE LEIGH LUSK COTA
RT 10 THREE MILE CURVE RD
LOGAN, WV 25601
Phone number: 304-752-2273
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Mailing Address
Mrs. CANDACE LEIGH LUSK COTA
PO BOX 211
KOPPERSTON, WV 24854-0211
Phone number:
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