Larry Macon Mccommack II
NPI #1053053157 in Charleston, West Virginia
Provider Information
- NPI Number
- 1053053157
- Entity Type
- Individual
- Name
- Larry Macon Mccommack II
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- Apr 9, 2022
- Last Updated
- Apr 9, 2022
Practice Location
- Address
- 102 PATRICK STREET PLZ
- City
- Charleston
- State
- West Virginia
- ZIP Code
- 25387-2444
- Phone
- (304) 233-3200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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