Provider Demographics
NPI:1003345422
Name:LINK, PATRICIA MARY
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARY
Last Name:LINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2998 CHARLESTON RD STE 5
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-5810
Mailing Address - Country:US
Mailing Address - Phone:304-786-1007
Mailing Address - Fax:304-606-3119
Practice Address - Street 1:2998 CHARLESTON ROAD, STE. 5
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271
Practice Address - Country:US
Practice Address - Phone:304-786-1007
Practice Address - Fax:304-606-3119
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96217171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV96217OtherACUPUNCTURE LICENSE