| Willow Ridge Pllc | |
|
333 N Jefferson St Lewisburg WV 24901-1116 | |
| (304) 645-7503 | |
| (304) 645-7582 |
| Full Name | Willow Ridge Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 333 N Jefferson St, Lewisburg, West Virginia |
| Authorized Official Name and Position | Rhonda L Hamm (PSYCHIATRIST/OWNER) |
| Authorized Official Contact | 3046457503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Ridge Pllc 333 N Jefferson St Lewisburg WV 24901-1116 Ph: (303) 645-7503 | Willow Ridge Pllc 333 N Jefferson St Lewisburg WV 24901-1116 Ph: (304) 645-7503 |
| NPI Number | 1720170335 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 11/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720170335 | NPI | - | NPPES |
| 3810001633 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 1649 (West Virginia) | Primary |
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