Individual
BRYAN FUGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6900 WEST COUNTRY CLUB DR, HUNTINGTON, WV 25705
(304) 733-1060
Mailing address
2822 COLONY POINTE, ASHLAND, KY 41102
(606) 325-9537
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT25336
FL
225XR0403X
Driving and Community Mobility Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7502079000
—
WV
Enumeration date
12/06/2006
Last updated
10/11/2024
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