Individual
MISTY DAWN ANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1522 OAKHURST DR, CHARLESTON, WV 25314-2442
(304) 601-3803
Mailing address
1522 OAKHURST DR, CHARLESTON, WV 25314-6100
(407) 982-4876
(407) 650-2758
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/24/2026
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