Individual
BRANDON VIATOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 PERSIMMON HOLLOW ROAD, STOLLINGS, WV 25646-0274
(337) 967-0493
Mailing address
PO BOX 274, STOLLINGS, WV 25646-0274
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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