NPI 1730628025

Tabula Rasa, PLLC

Organisation Exclusive Provider Organization Crab Orchard, WV

Practice location

Address: 1296 Robert C. Byrd Dr, 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: Director
Phone: (681) 238-5957

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence AP00943133 (WV)

Other Exclusive Provider Organization providers in West Virginia →

Registry record

NPI: 1730628025
Entity type: Organization
NPI issued: 20 Feb 2017
Record last updated: 20 Feb 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.