Healthcare Provider Details

I. General information

NPI: 1033055629
Provider Name (Legal Business Name): AARON WRISTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 OLD FAYETTE RD
OAK HILL WV
25901-6212
US

IV. Provider business mailing address

146 OLD FAYETTE RD
OAK HILL WV
25901-6212
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-7037
  • Fax: 304-469-7039
Mailing address:
  • Phone: 304-469-7037
  • Fax: 304-469-7039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: