Premium Martial Arts Wv LLC
Day Training, Developmentally Disabled Services in Dunbar, WV. Organization (NPI-2).
NPI number1083171078
StatusActive
Last updated in NPPESFeb 26, 2019
Details
- NPI
- 1083171078
- Entity type
- Organization (NPI-2)
- Legal business name
- Premium Martial Arts Wv LLC
- Organization subpart
- No
- Enumeration date
- Feb 26, 2019
- Last updated
- Feb 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251C00000X | Day Training, Developmentally Disabled Services | – | – | Yes |
Practice location
963 Dunbar Village PlzDunbar, WV 25064-3137
Phone 304-807-0251
Mailing address
602 Crossroads VlgNitro, WV 25143-2054
Phone 304-807-0251
Authorized official
Jessica Lynn Madden
Owner/Instructor
3048070251
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