Provider Demographics
NPI:1467686311
Name:FLORY, JOEL CHARLES (MFPT/CDT)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:CHARLES
Last Name:FLORY
Suffix:
Gender:M
Credentials:MFPT/CDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 PITTSBURGH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4162
Mailing Address - Country:US
Mailing Address - Phone:304-366-8950
Mailing Address - Fax:304-366-3519
Practice Address - Street 1:514 PITTSBURGH AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4162
Practice Address - Country:US
Practice Address - Phone:304-366-8950
Practice Address - Fax:304-366-3519
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1028-9815126900000X, 246ZA2600X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
No126900000XDental ProvidersDental Laboratory Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other