NPI 1407396773

Tabula Rasa, PLLC

Organisation Preferred Provider Organization Crab Orchard, WV

Practice location

Address: 1296 Robert C. Byrd Drive, Crab Orchard, WV 25827
Phone: (681) 238-5957
Fax: (681) 238-5958
Mailing address: PO Box 415, Crab Orchard, WV 25827-0415

Authorised official

Name: Kevin Blankenship
Title: Owner
Phone: (681) 238-5957

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 19121 (WV)

Other Preferred Provider Organization providers in West Virginia →

Registry record

NPI: 1407396773
Entity type: Organization
NPI issued: 6 Mar 2017
Record last updated: 6 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.