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1104429380
ETHAN M UNDERWOOD
NEW MARTINSVILLE, WV
NPI
1104429380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-11-19
Last Update Date
2020-11-19
Business Address
ETHAN M UNDERWOOD
145 PADUCAH DR
NEW MARTINSVILLE, WV 26155-2709
Phone number: 304-455-3220
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Mailing Address
ETHAN M UNDERWOOD
145 PADUCAH DR
NEW MARTINSVILLE, WV 26155-2709
Phone number: 304-455-3220
Copy
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