BILLY J BRAGG

BRIDGEPORT, WV
NPI1144376732
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: WV  000554)
Enumeration Date2007-01-26
Last Update Date2008-05-07
Business Address
Mr. BILLY J BRAGG
215 W MAIN ST
BRIDGEPORT, WV 26330-1748
Phone number: 304-842-6645
Mailing Address
Mr. BILLY J BRAGG
RR 1 BOX 359A
MOUNT CLARE, WV 26408-9731
Phone number: 304-622-6646
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