PENNY S DIVITA

CHARLESTON, WV
NPI1598744757
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: WV  1451)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: WV  1461)
Enumeration Date2006-01-16
Last Update Date2011-06-23
Business Address
-- PENNY S DIVITA DO
830 PENNSYLVANIA AVE STE 200
CHARLESTON, WV 25302-3302
Phone number: 304-388-2709
Mailing Address
-- PENNY S DIVITA DO
830 PENNSYLVANIA AVE STE 200
CHARLESTON, WV 25302-3302
Phone number: 304-388-2709