Individual
BETHANY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
644 GORDON DR, CHARLESTON, WV 25314-1762
(304) 610-6087
Mailing address
644 GORDON DR, CHARLESTON, WV 25314-1762
(304) 610-6087
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
108174
WV
Other
Enumeration date
06/20/2016
Last updated
07/21/2016
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