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Mary Ellen Bragg

Homemaker in Summersville, WV. Individual provider (NPI-1).

NPI number1962018010
StatusActive
Last updated in NPPESSep 23, 2020

Details

NPI
1962018010
Entity type
Individual (NPI-1)
Name
Mary Ellen Bragg
Sex
Female
Sole proprietor
No
Enumeration date
Sep 23, 2020
Certification date
Sep 23, 2020
Last updated
Sep 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376J00000X Homemaker––Yes

Practice location

1205 Broad St
Summersville, WV 26651-1805

Phone 304-872-1162

Mailing address

1205 Broad St
Summersville, WV 26651-1805

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