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1679169320
SUSAN JAYNE MICK
CHARLESTON, WV
NPI
1679169320
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2020-12-16
Last Update Date
2020-12-16
Business Address
SUSAN JAYNE MICK
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-344-0586
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Mailing Address
SUSAN JAYNE MICK
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-541-9832
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