Individual
ANDREW JACOB BUMGARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 JOHN MARSHALL DR, HUNTINGTON, WV 25755-0002
(304) 696-2639
(304) 696-3657
Mailing address
1225 CHARLESTON AVE, HUNTINGTON, WV 25701-3623
(937) 631-2464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001434
WV
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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