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Dwayne Edgar Wriston

Occupational Therapy Assistant in South Charleston, WV. Individual provider (NPI-1).

NPI number1316623754
StatusActive
Last updated in NPPESJun 22, 2023

Details

NPI
1316623754
Entity type
Individual (NPI-1)
Name
Dwayne Edgar Wriston
Sex
Male
Sole proprietor
No
Enumeration date
Jun 22, 2023
Certification date
Jun 22, 2023
Last updated
Jun 22, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224Z00000X Occupational Therapy AssistantC1636WVYes

Practice location

4825 Maccorkle Ave Sw Ste F
South Charleston, WV 25309-1365

Phone 304-346-9667 · Fax 304-346-9717

Mailing address

4825 Maccorkle Ave Sw Ste F
South Charleston, WV 25309-1365

Phone 304-346-9667 · Fax 304-346-9717

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