James David Roark

Individual provider Active NPI Personal Care Attendant · Logan, WV

NPI 1013519792 · NPPES record last updated Nov 9, 2020

Key facts

NPI
1013519792
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
258 Snap Branch Rd
Logan, WV 25601-3270
Phone
(304) 896-1524
NPI assigned
Nov 9, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

258 Snap Branch Rd
Logan, WV 25601-3270

Mailing address

258 Snap Branch Rd
Logan, WV 25601-3270
Phone (304) 896-1524

Other providers in Logan, WV

All providers in Logan, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.