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1609465988
MONTANA GREEN
CLAY, WV
NPI
1609465988
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-01-12
Last Update Date
2021-01-12
Business Address
MONTANA GREEN
172 MAIN STREET
CLAY, WV 25043
Phone number: 304-587-4251
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Mailing Address
MONTANA GREEN
PO BOX 655
CLAY, WV 25043-0655
Phone number:
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