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1750994364
KOKETA FITZGERALD
BLUEFIELD, WV
NPI
1750994364
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-08-25
Last Update Date
2023-01-10
Business Address
KOKETA FITZGERALD
239 ELLIS ST
BLUEFIELD, WV 24701-3653
Phone number: 304-922-9557
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Mailing Address
KOKETA FITZGERALD
239 ELLIS ST
BLUEFIELD, WV 24701-3653
Phone number: 304-922-9557
Copy
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