SHANE EDWARD BRAGG

SHADY SPRING, WV
NPI1548868474
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2020-10-13
Last Update Date2023-01-09
Business Address
SHANE EDWARD BRAGG
1520 IRISH MTN RD
SHADY SPRING, WV 25918
Phone number: 304-222-1156
Mailing Address
SHANE EDWARD BRAGG
PO BOX 2091
BEAVER, WV 25813-2091
Phone number: 304-222-1156
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