Individual
MISTY DIANNE BOLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 ELEVENTH STREET, ELKINS, WV 26241
(304) 636-9150
(304) 636-9157
Mailing address
40 ELEVENTH STREET, ELKINS, WV 26241
(304) 636-9150
(304) 636-9157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
84241
WV
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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