Individual
KRYSTAL ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 BUCKHANNON PIKE, NUTTER FORT, WV 26301-4307
(304) 622-1204
Mailing address
817 ELYSIAN AVE, MORGANTOWN, WV 26501-6711
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI03714600
NJ
183500000X
Pharmacist
Primary
RP0009406
WV
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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