Individual provider · Type 1 NPI
Shane Wriston, PA-C
Medical Physician Assistant · Ivydale, WV
NPI number
1609277201
Active
Practice location
797 Clinic Dr
Ivydale, WV 25113-8263
Fax (304) 286-2107
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 01845 (WV) |
Medical Physician Assistant: Definition to come...
4 other providers at this address
- Community Care of West Virginia, Inc.Federally Qualified Health Center (FQHC) Ivydale, WV NPI 1992754592
- Christine L. Jones, MDFamily Medicine Physician Ivydale, WV NPI 1801865290
- Jami LaughlinProfessional Counselor Ivydale, WV NPI 1255803011
- Michelle A. Klumpenhower, MED, EDSCase Manager/Care Coordinator Ivydale, WV NPI 1336917749
About NPI 1609277201
Shane Wriston, PA-C's National Provider Identifier is 1609277201, issued on Sep 15, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Ivydale, WV. The record was last updated on Aug 31, 2022.