RICKY LEE BROUGHTON

LOGAN, WV
NPI1639806227
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: WV  21-818)
Enumeration Date2022-08-03
Last Update Date2022-08-03
Business Address
RICKY LEE BROUGHTON PRSS
1112 ENTERPRISE DRIVE
LOGAN, WV 25601
Phone number: 304-896-6871
Mailing Address
RICKY LEE BROUGHTON PRSS
1112 ENTERPRISE DRIVE
LOGAN, WV 25601
Phone number: 304-896-6871
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