person
Samuel Bjorn Booth
Student in an Organized Health Care Education/Training Program in Charleston, West Virginia
NPI 1740976968

Samuel Bjorn Booth is a Student in an Organized Health Care Education/Training Program based in Fairhope, WV. Samuel Bjorn Booth practices in Charleston, WV. The NPI Number for Samuel Bjorn Booth is 1740976968 and holds a License No. (West Virginia).

The current practice location address for Samuel Bjorn Booth is 3200 Maccorkle Ave Se, Charleston, WV and can be reached out via phone at 304-388-4874.

Location: 3200 Maccorkle Ave Se, Charleston, WV, 36532-2108
person
Provider Profile Details
NPI Number
1740976968
Provider Name
Samuel Bjorn Booth
Credential
Provider Entity Type
Individual
Gender
Male
Address
3200 Maccorkle Ave Se, Charleston, WV, 36532-2108
Phone Number
304-388-4874
Fax Number
Provider Enumeration Date
04/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3200 Maccorkle Ave Se
City
State
Zip
25304-1227
Phone Number
304-388-4874
Fax Number
person
Provider Business Mailing Address Details
Address
3200 Maccorkle Ave Se
City
State
Zip
25304-1227
Phone Number
304-388-4874
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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