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1902519978
JAQUALLA SMITH
CHARLESTON, WV
NPI
1902519978
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WV 2910)
Enumeration Date
2023-01-04
Last Update Date
2024-07-22
Business Address
JAQUALLA SMITH
4407 MACCORKLE AVE SE STE 2
CHARLESTON, WV 25304-2541
Phone number: 304-925-0392
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Mailing Address
JAQUALLA SMITH
632 HAL GREER BLVD APT 3
HUNTINGTON, WV 25701-2975
Phone number: 304-222-4593
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