TABULA RASA, PLLC

CRAB ORCHARD, WV
NPI1730628025
Entity TypeOrganization
Authorized ContactKEVIN BLANKENSHIP
Director
681-238-5957
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: WV  AP00943133)
Enumeration Date2017-02-20
Last Update Date2017-02-20
Business Address
TABULA RASA, PLLC
1296 ROBERT C. BYRD DR
CRAB ORCHARD, WV 25827
Phone number: 681-238-5957
Mailing Address
TABULA RASA, PLLC
PO BOX 415
CRAB ORCHARD, WV 25827-0415
Phone number: 681-238-5957