NATHANIEL SOUTHERN

CHARLESTON, WV
NPI1780455691
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2024-01-10
Last Update Date2024-01-10
Business Address
NATHANIEL SOUTHERN
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-344-0586
Mailing Address
NATHANIEL SOUTHERN
PO BOX 20112
CHARLESTON, WV 25362-1112
Phone number: 304-344-0586