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Individual

BRENDA SHULL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
540 5TH AVE, HUNTINGTON, WV 25701-1908
(304) 697-0022
Mailing address
540 5TH AVE, HUNTINGTON, WV 25701-1908
(304) 697-0022

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
00000
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NONE
WV
Enumeration date
01/02/2023
Last updated
01/02/2023
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