Individual
CONNOR JAKOB WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 GATEWATER RD, CROSS LANES, WV 25313-1408
(304) 206-2296
Mailing address
104 TAYLOR ST, HURRICANE, WV 25526-1518
(304) 550-2924
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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