DEREK RAYNES

CHARLESTON, WV
NPI1770035594
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WV  AT001306)
Enumeration Date2016-10-27
Last Update Date2016-10-27
Business Address
-- DEREK RAYNES MS, ATC, PES, CFCE
5510 MACCORKLE AVE SE
CHARLESTON, WV 25304-2320
Phone number: 304-720-5433
Mailing Address
-- DEREK RAYNES MS, ATC, PES, CFCE
5510 MACCORKLE AVE SE
CHARLESTON, WV 25304-2320
Phone number: 304-720-5433
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