Individual
DALLAS JAMES MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
215 BROOKSHIRE LN, BECKLEY, WV 25801-6729
(304) 253-1077
(304) 253-9611
Mailing address
215 BROOKSHIRE LN, BECKLEY, WV 25801-6729
(304) 253-1077
(304) 253-9611
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
958
WV
Other
Enumeration date
09/03/2008
Last updated
01/26/2010
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