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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Kyle Humphrey | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Kyle | [sources] | |||
| Last name | Humphrey | [sources] | |||
| NPI | 1235568569 | [sources] | |||
| Address | PO Box 350, Beaver, WV 25813 | [sources] | |||
| Last change | Last processed | First seen | |||
Medicaid providers sanctioned in West Virginia's Medicaid program.
United States · MMIS
us-fed-excl-kyle-wesley-humphrey-25813-beaver · us-medwv-8285e612242d2703076510d2897988edd8b1053eFor experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| PO Box 350, Beaver, WV 25813 | United States | |