Most Relevant Information
Provider Data
NPI Number: | 1003290651 |
Provider Name: | DUSTIN CRITES |
Entity Type: | Individual |
Taxonomy Code: | 363A00000X |
Specialty: | Physician Assistant |
License Number: | 1901 |
Most Important Dates
Enumeration Date: | 07/14/2015 |
Last Updated: | 07/14/2015 |
Provider Practice Location
4605 MACCORKLE AVE SW
SOUTH CHARLESTON
WV
253091311
Practice Location Phone/Fax
Phone: | 3047663601 |
Fax: | 3047663477 |
Provider Mailing Location
1431 CENTERPOINT BLVD
SUITE 100
KNOXVILLE
TN
379321984
Provider Mailing Phone/Fax
Phone: | 8655398000 |
Fax: | 8656945128 |