Individual
HEATHER BRISTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 BURROUGHS ST STE 102, MORGANTOWN, WV 26505-3389
(304) 285-5500
Mailing address
652 WEBSTER PIKE, GRAFTON, WV 26354-8200
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
35736
WV
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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