Most Relevant Information
Provider Data
| NPI Number: | 1003400425 |
| Provider Name: | TABETHA CRISLIP |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/25/2021 |
| Last Updated: | 02/26/2021 |
Provider Practice Location
2242 WILLIAMS HWY
WILLIAMSTOWN
WV
261878266
Practice Location Phone/Fax
| Phone: | 3043756480 |
| Fax: |
Provider Mailing Location
2242 WILLIAMS HWY
WILLIAMSTOWN
WV
261878266
Provider Mailing Phone/Fax
| Phone: | 3043756480 |
| Fax: |