Individual
NATHAN SANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 4TH AVE, HUNTINGTON, WV 25701-1219
(304) 523-3502
Mailing address
111 4TH AVE, HUNTINGTON, WV 25701-1219
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0010241
WV
Other
Enumeration date
08/02/2017
Last updated
08/07/2017
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