Provider Information for 1922595495
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AMY LYNN BRAGG MA
Sex: Female
NPI: 1922595495
Last Updated: 2018-04-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1922595495 | ||||||||||||
| Enumeration Date | 2018-04-19 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 401 10TH ST HUNTINGTON, WV 25701-2200 United States Phone: 304-523-9673 | Fax:304-523-9674 | ||||||||||||
| Primary Practice Address | 401 10TH ST HUNTINGTON, WV 25701-2200 United States Phone: 304-523-9673 | Fax:304-523-9674 | ||||||||||||
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