JACKIE D SHORTER

PINEVILLE, WV
NPI1871676874
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: WV  299)
Enumeration Date2006-10-23
Last Update Date2010-02-12
Business Address
-- JACKIE D SHORTER PAC
1650 MAIN STREET
PINEVILLE, WV 24874
Phone number: 304-732-6735
Mailing Address
-- JACKIE D SHORTER PAC
PO BOX 1650 FAMILY HEALTHCARE ASSOC INC
PINEVILLE, WV 24874
Phone number: 304-732-6735
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