SHANE MODESITT

PARKERSBURG, WV
NPI1104660620
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2024-06-20
Last Update Date2024-06-20
Business Address
SHANE MODESITT
425 JULIANA ST # NA
PARKERSBURG, WV 26101-5352
Phone number: 304-893-9777
Mailing Address
SHANE MODESITT
425 JULIANA ST # NA
PARKERSBURG, WV 26101-5352
Phone number: 304-893-9777
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