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Roger Mark Booth

NPI Registration Record

Provider / OrganizationNPIDate Certified
ROGER MARK BOOTH12751500472020-06-28
Entity TypeIndividual
Provider NameMr. Roger Mark Booth Jr. NP-C
Practice Office Address1540 SPRING VALLEY DR
HUNTINGTON, WV US
Practice Office Telephone3046544035
Mailing Address1540 SPRING VALLEY DR
HUNTINGTON, WV 257049501 US
Business Telephone3046544035
Contact Endpoints
CONNECT URL []Huntington
HPT Codes
CodeLicense NoState
363LG0600X PRIMARY105246 WV
OPI Codes

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