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1265177703
JACOB EDMOND
HUNTINGTON, WV
NPI
1265177703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
(Licence: WV 22-929)
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2022-04-29
Last Update Date
2022-12-09
Business Address
JACOB EDMOND PR
137 8TH AVE W
HUNTINGTON, WV 25701-2510
Phone number: 681-888-5291
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Mailing Address
JACOB EDMOND PR
137 8TH AVE W
HUNTINGTON, WV 25701-2510
Phone number: 681-888-5291
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