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1790371029
GARY CHAMP
CLAY, WV
NPI
1790371029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-12-21
Last Update Date
2020-12-21
Business Address
GARY CHAMP
172 MAIN STREET
CLAY, WV 25043-2504
Phone number: 304-587-4251
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Mailing Address
GARY CHAMP
PO BOX 455
CLAY, WV 25043-0455
Phone number:
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