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Individual

DR. CHESTER T. FRETHIEM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
12301 GRAPEFIELD RD, BASTIAN, VA 24314-4547
(276) 688-4331
(276) 688-4336
Mailing address
PO BOX 5648, PRINCETON, WV 24740-5648
(304) 920-2534

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
747
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810003905
WV
Enumeration date
09/22/2006
Last updated
04/07/2020
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