BENJAMIN TACKETT

LOGAN, WV
NPI1265959704
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: WV  66717)
Enumeration Date2017-08-25
Last Update Date2017-08-25
Business Address
BENJAMIN TACKETT FNP
140 STOLLINGS AVE STE 1
LOGAN, WV 25601-4035
Phone number: 304-752-2555
Mailing Address
BENJAMIN TACKETT FNP
140 STOLLINGS AVE STE 1
LOGAN, WV 25601-4035
Phone number:
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