Organization
BRAXTON VA CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MAYERICK (DIRECTOR, BUSINESS DEVELOPMENT)
(202) 254-0339
Entity
Organization
Contact information
Practice address
707 ELK ST, GASSAWAY, WV 26624-1113
(304) 364-8941
(304) 364-8943
Mailing address
707 ELK ST, GASSAWAY, WV 26624-1113
(304) 364-8941
(304) 364-8943
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2006
Last updated
08/22/2020
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