| Country Roads Aba | |
|
108 Liberty Sq Hurricane WV 25526-8809 | |
| (304) 840-1585 | |
| Not Available |
| Full Name | Country Roads Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 108 Liberty Sq, Hurricane, West Virginia |
| Authorized Official Name and Position | Christopher Michael Crytzer (OWNER) |
| Authorized Official Contact | 3048401585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Roads Aba 108 Liberty Sq Hurricane WV 25526-8809 Ph: (304) 840-1585 | Country Roads Aba 108 Liberty Sq Hurricane WV 25526-8809 Ph: (304) 840-1585 |
| NPI Number | 1033816129 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033816129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 261QD1600X | Clinic/center - Developmental Disabilities | (* (Not Available)) | Secondary |
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