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1740002815
KODA MICHAEL SAMPSON
CLARKSBURG, WV
NPI
1740002815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician Personal Care Attendant
Enumeration Date
2024-10-29
Last Update Date
2024-10-29
Business Address
KODA MICHAEL SAMPSON
636 HANOVER ST
CLARKSBURG, WV 26301-7537
Phone number: 740-647-3613
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Mailing Address
KODA MICHAEL SAMPSON
636 HANOVER ST
CLARKSBURG, WV 26301-7537
Phone number: 740-647-3613
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