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1740826064
SAMUEL ELI BROOKOVER
BRIDGEPORT, WV
NPI
1740826064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WV 2080)
Enumeration Date
2019-11-21
Last Update Date
2019-11-21
Business Address
SAMUEL ELI BROOKOVER MOTR/L
1000 MAPLEWOOD DR
BRIDGEPORT, WV 26330-9115
Phone number: 304-848-0200
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Mailing Address
SAMUEL ELI BROOKOVER MOTR/L
2991 DOOLIN RUN RD
NEW MARTINSVILLE, WV 26155-7830
Phone number: 304-455-5901
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