Individual
BRADLEY MASON STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
306 STANAFORD RD, BECKLEY, WV 25801-3142
(304) 255-3000
Mailing address
115 FLORIDA AVE, CRAB ORCHARD, WV 25827-9539
(304) 575-7821
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
115860
WV
Other
Enumeration date
01/26/2023
Last updated
03/17/2023
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