OTIS MACK

CHARLESTON, WV
NPI1184216749
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2021-02-05
Last Update Date2021-02-05
Business Address
OTIS MACK
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-344-0586
Mailing Address
OTIS MACK
PO BOX 20112
CHARLESTON, WV 25362-1112
Phone number:
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