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1730811332
CRESTYN SLADE WHITE
ROANOKE, VA
NPI
1730811332
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WV 2710)
Enumeration Date
2022-06-30
Last Update Date
2023-06-08
Business Address
CRESTYN SLADE WHITE PA-C
806 WASENA AVE SW APT 326
ROANOKE, VA 24015-5358
Phone number: 304-413-3597
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Mailing Address
CRESTYN SLADE WHITE PA-C
20 HALL VALLEY CT
BRIDGEPORT, WV 26330-9606
Phone number: 304-413-3597
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