Individual
BRAEDEN CHASE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
636 MADISON AVE, MORGANTOWN, WV 26501
(304) 238-6141
Mailing address
636 MADISON AVE, MORGANTOWN, WV 26501-6720
(304) 238-6141
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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