Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4328 | WV |
Y | 213EG0000X | General Practice | 4328 | WV |
NPI | 1003308495 |
---|---|
Provider Name | Lindsey Lamm |
First Address | Morgantown, WV 26505-1822 |
Second Address | Buckhannon, WV 26201-2715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2018 |
Last Update Date | 01/06/2018 |