Individual
BONNIE IRENE BRACKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
242 LOCUST ST, RAINELLE, WV 25962-1024
(681) 291-3034
Mailing address
242 LOCUST ST, RAINELLE, WV 25962-1024
(681) 291-3034
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
01/09/2023
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