Provider Demographics
NPI:1124277587
Name:WOMYN, INC.
Entity type:Organization
Organization Name:WOMYN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-768-7770
Mailing Address - Street 1:4607 MACCORKLE AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1364
Mailing Address - Country:US
Mailing Address - Phone:304-768-7770
Mailing Address - Fax:304-768-7772
Practice Address - Street 1:4607 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1364
Practice Address - Country:US
Practice Address - Phone:304-768-7770
Practice Address - Fax:304-768-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2105174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty