Individual
CRYSTAL BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
200 VETERANS AVE, BECKLEY, WV 25801-6444
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
33178
WV
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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