Individual
MR. LEON HASTINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT/L
Contact information
Practice address
415 BENEDUM DR, BRIDGEPORT, WV 26330-1503
(304) 842-9887
(304) 842-9888
Mailing address
415 BENEDUM DR, BRIDGEPORT, WV 26330-1503
(304) 842-9887
(304) 842-9888
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1121
WV
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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