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1467130492
DETARRA JACKSON
BARBOURSVILLE, WV
NPI
1467130492
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2023-07-10
Last Update Date
2023-07-10
Business Address
DETARRA JACKSON
652 MAIN ST
BARBOURSVILLE, WV 25504-1439
Phone number: 304-302-0707
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Mailing Address
DETARRA JACKSON
652 MAIN ST
BARBOURSVILLE, WV 25504-1439
Phone number:
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