Individual
PHILLIP BARTRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6900 COUNTRY CLUB DR, HUNTINGTON, WV 25705-2000
(304) 733-1060
Mailing address
1112 OAKRIDGE CT, RUSSELL, KY 41169-1414
(606) 833-8781
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1553
WV
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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