| Organization Name: | WETZEL COUNY COA |
| NPI Number: | 1528483302 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA HALL CULLEY (REGISTER NURSE) |
| Mailing Address: | 145 Paducah Dr New Martinsville |
| State: | WV US |
| Postal Code: | 261552709 |
| Phone Number: | 3044553220 |
| Fax Number: | 3044550280 |
| NPI Enumeration Date: | 03/03/2014 |
| NPI Last Update Date: | 03/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 10363962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |