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1255929402
MICAH PENCO
PARKERSBURG, WV
NPI
1255929402
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2021-01-04
Last Update Date
2021-01-04
Business Address
MICAH PENCO
3702 CAMDEN AVE
PARKERSBURG, WV 26101-6333
Phone number: 304-485-6405
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Mailing Address
MICAH PENCO
3702 CAMDEN AVE
PARKERSBURG, WV 26101-6333
Phone number: 304-485-6405
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