Individual
MR. JOHN RUSSELL ATKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1007 38TH ST, VIENNA, WV 26105-2741
(304) 295-9243
(304) 428-4500
Mailing address
1007 38TH ST., VIENNA, WV 26105-2741
(304) 295-9243
(304) 428-4500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
309
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165376000
—
WV
Enumeration date
01/28/2008
Last updated
01/28/2008
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