Individual
BRENT ALEXANDER ROARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1000 VERMILLION ST, ATHENS, WV 24712-9027
(304) 384-6320
(304) 384-5117
Mailing address
1000 VERMILLION ST, ATHENS, WV 24712-9027
(304) 384-6320
(304) 384-5117
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001370
WV
Other
Enumeration date
12/31/2017
Last updated
12/31/2017
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