Individual
BRADLEE SCOTT WEASENFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 JONES ST APT 503, PIEDMONT, WV 26750-1017
(681) 412-9630
Mailing address
51 JONES ST APT 503, PIEDMONT, WV 26750-1017
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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