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1477760601
BRIAN KIDD
BEAVER, WV
NPI
1477760601
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-17
Last Update Date
2007-07-08
Business Address
-- BRIAN KIDD BS
175 PHILPOT LANE
BEAVER, WV 25813
Phone number: 304-254-9262
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Mailing Address
-- BRIAN KIDD BS
321 VINE ST
BECKLEY, WV 25801-4845
Phone number: 304-640-3748
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