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1235430257
LORI-ANN MICHELLE JACKSON
MANNINGTON, WV
NPI
1235430257
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WV 2846)
Enumeration Date
2010-11-08
Last Update Date
2012-05-24
Business Address
LORI-ANN MICHELLE JACKSON DPT
116 MARKET ST
MANNINGTON, WV 26582-1131
Phone number: 304-986-1568
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Mailing Address
LORI-ANN MICHELLE JACKSON DPT
12 HARTMAN PLZ
BUCKHANNON, WV 26201-2230
Phone number: 304-473-0531
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