Individual
MR. CHRISTOPHER SCOTT BRACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2194 BOOTH RD, KENOVA, WV 25530-9544
(304) 453-6351
Mailing address
2194 BOOTH RD, KENOVA, WV 25530-9544
(304) 453-1635
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010-01314
NC
Other
Enumeration date
01/06/2009
Last updated
08/03/2012
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