Individual
KRISTOPHER CALEB PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 ANGUS E PEYTON DR, SOUTH CHARLESTON, WV 25303-1600
(304) 746-2088
Mailing address
1575 ARNOLD CT, HUNTINGTON, WV 25705-2909
(304) 673-9546
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
97394
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
97394
WV
Other
Enumeration date
04/05/2022
Last updated
08/21/2024
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