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1104562313
NATHAN ALEXANDER FRAVOR
CHARLESTON, WV
NPI
1104562313
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-05-10
Last Update Date
2022-05-10
Business Address
NATHAN ALEXANDER FRAVOR DO
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304-1297
Phone number: 304-388-5590
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Mailing Address
NATHAN ALEXANDER FRAVOR DO
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304-1297
Phone number: 304-388-5590
Copy
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