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1275150047
ROGER MARK BOOTH
HUNTINGTON, WV
NPI
1275150047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: WV 105246)
Enumeration Date
2020-06-28
Last Update Date
2020-06-28
Business Address
Mr. ROGER MARK BOOTH NP-C
1540 SPRING VALLEY DR
HUNTINGTON, WV 25704-9501
Phone number: 304-654-4035
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Mailing Address
Mr. ROGER MARK BOOTH NP-C
1540 SPRING VALLEY DR
HUNTINGTON, WV 25704-9501
Phone number: 304-654-4035
Copy
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