Individual
CRYSTAL NOELLE VANBLARICOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1213 N WALKER ST, PRINCETON, WV 24740-2536
(304) 716-1651
Mailing address
1213 N WALKER ST, PRINCETON, WV 24740-2536
(304) 716-1651
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603329
VA
Other
Enumeration date
05/23/2012
Last updated
12/18/2012
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