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1962453191
CRYSTAL H BASTIN
SOUTH CHARLESTON, WV
NPI
1962453191
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Former Name
CRYSTAL LEA HEATHERMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WV 20368)
Enumeration Date
2006-05-12
Last Update Date
2022-01-13
Business Address
DR. CRYSTAL H BASTIN M.D.
4820 KENTUCKY ST
SOUTH CHARLESTON, WV 25309
Phone number: 304-720-0390
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Mailing Address
DR. CRYSTAL H BASTIN M.D.
4605 MACCORKLE AVE SW THS PHYSICIAN PARTNERS, INC. - ADMIN OFC
SOUTH CHARLESTON, WV 25309-1311
Phone number: 304-414-4800
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