Organization
IMAGINE MEDISPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA LEA PHARES FNP-BC (NURSE PRACTITIONER)
(304) 574-6144
Entity
Organization
Contact information
Practice address
321 DRY HILL RD, BECKLEY, WV 25801-2601
(304) 252-4154
Mailing address
127 OAKWOOD CIR, FAYETTEVILLE, WV 25840-6648
(304) 574-6144
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN77359-FNP-BC
WV
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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