Individual
KRISTA GASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
70 PROSPECT AVE, CHARLES TOWN, WV 25414-1170
(304) 724-1101
(304) 724-1105
Mailing address
600 PINNACLE DR, BUNKER HILL, WV 25413-3555
(304) 229-2515
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1281
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119003497
OTR LICENSE
VA
01
—
02025980
LIABILITY INSURANCE
—
01
—
1281
OTR LICENSE
WV
Enumeration date
03/23/2007
Last updated
07/08/2007
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