LARRY MACON MCCOMMACK

CHARLESTON, WV
NPI1053053157
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2022-04-09
Last Update Date2022-04-09
Business Address
LARRY MACON MCCOMMACK
102 PATRICK STREET PLZ
CHARLESTON, WV 25387-2444
Phone number: 304-233-3200
Mailing Address
LARRY MACON MCCOMMACK
102 PATRICK STREET PLZ
CHARLESTON, WV 25387-2444
Phone number:
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