Individual
JACKLYNN RAE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
449 BAYS RD, BIRCH RIVER, WV 26610
(304) 880-3473
Mailing address
PO BOX 295, BIRCH RIVER, WV 26610-0295
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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