Provider Demographics
NPI:1386445039
Name:ELKINS, BRYAN T JR
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:T
Last Name:ELKINS
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 CLINES COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:LASHMEET
Mailing Address - State:WV
Mailing Address - Zip Code:24733-9692
Mailing Address - Country:US
Mailing Address - Phone:304-409-0390
Mailing Address - Fax:
Practice Address - Street 1:581 CLINES COUNTRY RD
Practice Address - Street 2:
Practice Address - City:LASHMEET
Practice Address - State:WV
Practice Address - Zip Code:24733-9692
Practice Address - Country:US
Practice Address - Phone:304-409-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant