JACKIE TANNER

CHARLESTON, WV
NPI1215694880
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2021-11-18
Last Update Date2021-11-18
Business Address
JACKIE TANNER
200 ASSOCIATION DR STE 130
CHARLESTON, WV 25311-1277
Phone number: 304-988-4200
Mailing Address
JACKIE TANNER
200 ASSOCIATION DR STE 130
CHARLESTON, WV 25311-1277
Phone number: 304-988-4200
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