Braxton Va Clinic

NPI #1194776823 in Gassaway, West Virginia

Provider Information

NPI Number: 1194776823
Entity Type: Organization
Organization Name: Braxton Va Clinic
Primary Specialty: Clinic/Center - VA
Enumeration Date: May 15, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 707 ELK ST
City: Gassaway
State: West Virginia
ZIP Code: 26624-1113
Phone: (304) 364-8941

Authorized Official

Name: BARBARA MAYERICK
Title: DIRECTOR, BUSINESS DEVELOPMENT
Phone: (202) 254-0339

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - VA — VA	261QV0200X	Primary

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