PHYLLIS JACKSON

CHARLESTON, WV
NPI1831811041
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2022-09-14
Last Update Date2022-09-14
Business Address
PHYLLIS JACKSON
1599 2ND AVE
CHARLESTON, WV 25387-2514
Phone number: 304-453-4663
Mailing Address
PHYLLIS JACKSON
PO BOX 20112
CHARLESTON, WV 25362-1112
Phone number: 304-453-4663
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