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1477373215
JACOB CLARK
CHARLESTON, WV
NPI
1477373215
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2024-10-16
Last Update Date
2024-10-16
Business Address
JACOB CLARK
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-453-4663
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Mailing Address
JACOB CLARK
PO BOX 20112
CHARLESTON, WV 25362-1112
Phone number: 304-453-4663
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