Individual
BRENT BLEDSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 N EISENHOWER DR APT A, BECKLEY, WV 25801-3109
(304) 254-9610
Mailing address
550 N EISENHOWER DR APT A, BECKLEY, WV 25801-3109
(304) 254-9610
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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