Provider Demographics
NPI:1174345920
Name:MCGLOTHLIN, KRISTOPHER SETH
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:SETH
Last Name:MCGLOTHLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 DENVER DR
Mailing Address - Street 2:
Mailing Address - City:BICKMORE
Mailing Address - State:WV
Mailing Address - Zip Code:25019-9687
Mailing Address - Country:US
Mailing Address - Phone:304-587-6003
Mailing Address - Fax:
Practice Address - Street 1:99 DENVER DR
Practice Address - Street 2:
Practice Address - City:BICKMORE
Practice Address - State:WV
Practice Address - Zip Code:25019-9687
Practice Address - Country:US
Practice Address - Phone:304-587-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant