Individual
TYLER GAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-5432
Mailing address
63 JOSEPHINE AVE APT B, MADISON, WV 25130-1388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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