Organization
MOUNTAIN ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY PERSINGER CRNA (OWNER)
(304) 542-3927
Entity
Organization
Contact information
Practice address
2830 DAVIS STURT ROAD, LEWISBURG, WV 24901
(304) 731-2313
(304) 647-4570
Mailing address
PO BOX 631, LEWISBURG, WV 24901-0631
(304) 731-2313
(304) 647-4570
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2245-8943
WV
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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