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1851987093
POLLY LARISSA MAYNARD
HUNTINGTON, WV
NPI
1851987093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-12-11
Last Update Date
2020-12-11
Business Address
POLLY LARISSA MAYNARD
4329 HUGHES BRANCH RD
HUNTINGTON, WV 25701-9768
Phone number: 304-733-1094
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Mailing Address
POLLY LARISSA MAYNARD
59 COW CREEK RD
OMAR, WV 25638-9518
Phone number: 304-946-4444
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