Provider Demographics
NPI:1770169591
Name:ARMSTRONG, HENRY GERALD JR
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:GERALD
Last Name:ARMSTRONG
Suffix:JR
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:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:CLEAR FORK
Mailing Address - State:WV
Mailing Address - Zip Code:24822-0223
Mailing Address - Country:US
Mailing Address - Phone:304-896-4211
Mailing Address - Fax:
Practice Address - Street 1:2307 ELK LICK RD
Practice Address - Street 2:
Practice Address - City:CLEAR FORK
Practice Address - State:WV
Practice Address - Zip Code:24822
Practice Address - Country:US
Practice Address - Phone:304-896-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant