Provider Information for 1831357938
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JOSALYN ICE
Sex: Female
NPI: 1831357938
Last Updated: 2009-11-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1831357938 | ||||||||
| Enumeration Date | 2008-05-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2606 NATIONAL RD WHEELING, WV 26003-5370 United States Phone: 304-242-7060 | Fax:304-242-7076 | ||||||||
| Primary Practice Address | 2606 NATIONAL RD WHEELING, WV 26003-5370 United States Phone: 304-242-7060 | Fax:304-242-7076 | ||||||||
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