Individual
MR. MAX CROW III
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) 746-2500
Mailing address
2071 DECKER DR, CULLODEN, WV 25510-8502
(304) 634-9731
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
116716
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2022
Last updated
12/12/2023
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