Individual
BRENNA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6135 SISSONVILLE DR, CHARLESTON, WV 25312-9444
(304) 343-8030
(304) 343-8031
Mailing address
6135 SISSONVILLE DR, CHARLESTON, WV 25312-9444
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0009978
WV
Other
Enumeration date
01/09/2017
Last updated
01/29/2018
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