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1639111768
JERRY A. QUISENBERRY
MADISON, WV
NPI
1639111768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WV 867)
Enumeration Date
2006-06-12
Last Update Date
2018-02-12
Business Address
Mr. JERRY A. QUISENBERRY PA-C
471 MAIN ST
MADISON, WV 25130-1223
Phone number: 304-369-5170
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Mailing Address
Mr. JERRY A. QUISENBERRY PA-C
7400 LYNN AVE
HAMLIN, WV 25523-1138
Phone number: 304-824-5806
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